Provider Demographics
NPI:1831154277
Name:RECTOR, JERALD EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JERALD
Middle Name:EDWARD
Last Name:RECTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2564
Mailing Address - Country:US
Mailing Address - Phone:402-421-0904
Mailing Address - Fax:402-421-0946
Practice Address - Street 1:5000 N 26TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4749
Practice Address - Country:US
Practice Address - Phone:402-435-5300
Practice Address - Fax:402-742-8405
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39344207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
251517OtherMIDLANDS CHOICE
01-07090OtherUHC
03140OtherBCBS
251517OtherMIDLANDS CHOICE
280478Medicare PIN
01-07090OtherUHC
P00445364Medicare PIN