Provider Demographics
NPI:1538187893
Name:CITTA, JASON MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:MICHAEL
Last Name:CITTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:611 W FRANCIS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0614
Mailing Address - Country:US
Mailing Address - Phone:308-534-2532
Mailing Address - Fax:308-534-6615
Practice Address - Street 1:611 W FRANCIS ST STE 100
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-0614
Practice Address - Country:US
Practice Address - Phone:308-534-5325
Practice Address - Fax:308-534-6615
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE21468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEH26883Medicare UPIN