Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 17169 | WI |
NPI | 1093739427 |
---|---|
Provider Name | John Florian Hussa |
First Address | Ashland, WI 54806-3626 |
Second Address | Ashland, WI 54806-3626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 07/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0979600000 | BAYFIELD CTY (01) | |
2632839 10 | M MA (01) | WI |
31192600 | (05) | WI |
391662030 | ASHLAND CTY (01) | |
4060137 | DEA AH (01) | |
E33330 | (02) |