Provider Demographics
NPI:1871555649
Name:JAKSHA, JONATHAN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ANDREW
Last Name:JAKSHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1010 N 102ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2122
Mailing Address - Country:US
Mailing Address - Phone:833-228-6889
Mailing Address - Fax:877-853-0376
Practice Address - Street 1:17310 WRIGHT ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2405
Practice Address - Country:US
Practice Address - Phone:833-228-6889
Practice Address - Fax:877-853-0376
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY9680A2085R0202X
CAA924362085R0202X
GUMC-1652085R0202X
ND151072085R0202X
MO20050208382085R0202X
IDM93952085R0202X
WAMD000453332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology