Provider Demographics
NPI:1205873171
Name:VERZAL, JOSEPH L (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:VERZAL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2810 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2909
Mailing Address - Country:US
Mailing Address - Phone:308-865-2570
Mailing Address - Fax:308-865-2508
Practice Address - Street 1:16909 LAKESIDE HILLS CT STE 208
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4663
Practice Address - Country:US
Practice Address - Phone:402-717-0820
Practice Address - Fax:308-865-2508
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE865363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE229242OtherMIDLANDS CHOICE
NE37482OtherBCBS OF NEBRASKA
NE278016Medicare ID - Type Unspecified
NE229242OtherMIDLANDS CHOICE