Basic Information
Provider Information
NPI: 1699081117
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUS
FirstName: NIR
MiddleName: JOSEPH
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2699
Address2:  
City: PENSACOLA
State: FL
PostalCode: 325132699
CountryCode: US
TelephoneNumber: 8504754500
FaxNumber:  
Practice Location
Address1: 5149 N 9TH AVE
Address2: SUITE 246
City: PENSACOLA
State: FL
PostalCode: 325048756
CountryCode: US
TelephoneNumber: 8504166159
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/21/2010
LastUpdateDate: 10/22/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0102XME112915FLY Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
208600000XME112915FLN Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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