Provider Demographics
NPI:1265735682
Name:DAVID JAMESON
Entity type:Organization
Organization Name:DAVID JAMESON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CMOM
Authorized Official - Phone:402-764-2491
Mailing Address - Street 1:1356 126TH RD
Mailing Address - Street 2:
Mailing Address - City:STROMSBURG
Mailing Address - State:NE
Mailing Address - Zip Code:68666-6240
Mailing Address - Country:US
Mailing Address - Phone:402-764-2491
Mailing Address - Fax:402-764-4033
Practice Address - Street 1:531 BEEBE ST # 546
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:NE
Practice Address - Zip Code:68651
Practice Address - Country:US
Practice Address - Phone:402-747-8851
Practice Address - Fax:402-747-1407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID JAMESON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty