Provider Demographics
NPI:1740262385
Name:AITA, JOHN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:AITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8601 W DODGE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3457
Mailing Address - Country:US
Mailing Address - Phone:402-392-2882
Mailing Address - Fax:402-392-2092
Practice Address - Street 1:8601 W DODGE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3457
Practice Address - Country:US
Practice Address - Phone:402-392-2882
Practice Address - Fax:402-392-2092
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE117822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3680OtherBC/BS
NE4707198400Medicaid
NE9001OtherMIDLANDS CHOICE
NE3680OtherBC/BS
097811Medicare ID - Type Unspecified