1275587743 NPI number — HOODY & LANSPA FAMILY PRACTICE P C

Table of content: DR. JAMES CLIFTON JOHNSON MD (NPI 1376548222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275587743 NPI number — HOODY & LANSPA FAMILY PRACTICE P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOODY & LANSPA FAMILY PRACTICE P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275587743
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4920 CENTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68106-3219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-558-6625
Provider Business Mailing Address Fax Number:
402-558-5013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4920 CENTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68106-3219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-558-6625
Provider Business Practice Location Address Fax Number:
402-558-5013
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROUSH
Authorized Official First Name:
VALERIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
402-558-2500

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 261524 . This is a "MEDICARE NUMBER FOR DR. ZAWAIDEH" identifier . This identifiers is of the category "OTHER".




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