STAR CITY COSMETIC SURGERY LLC NPI 1669138905

NPI Information

NPI: 1669138905
Provider Name: STAR CITY COSMETIC SURGERY LLC

Doing Business As: JACOBSON COSMETIC SURGERY

Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
1630 S 70TH ST STE 202
LINCOLN, NE
ZIP 68506
Phone: (531) 254-5458
Get Directions

STAR CITY COSMETIC SURGERY LLC is a facial plastic surgery otolaryngology in Lincoln, NE. The provider is an otolaryngologist who specializes in facial plastic surgery. STAR CITY COSMETIC SURGERY LLC NPI is 1669138905. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jacobson Cosmetic Surgery.

The provider's business location address is:

1630 S 70TH ST STE 202
LINCOLN, NE
ZIP 68506-500
Phone: (531) 254-5458
Fax: (531) 254-5065

The provider's authorized official is Jessica Paige Jacobson .
The authorized official title is Physician/owner and has the following contact phone number (402) 890-6249.

The enumeration date for this NPI number is 11/10/2021 and was last updated on 2/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2082S0099X	Plastic Surgery	Plastic Surgery Within the Head and Neck	No
2	261QM2500X	Clinic/Center	Medical Specialty	No
3	207YS0123X	Otolaryngology	Facial Plastic Surgery	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2017014908	OTHER	MISSOURI	STATE MEDICAL LICENSE
2	2369	OTHER	NEBRASKA	STATE MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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