Healthcare Provider Details

I. General information

NPI: 1912697533
Provider Name (Legal Business Name): THOMPSON HUSS ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4353 DODGE ST
OMAHA NE
68131-2709
US

IV. Provider business mailing address

15932 MARY ST
OMAHA NE
68116-4075
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CLARK THOMPSON
Title or Position: OWNER, CRNA
Credential: CRNA
Phone: 402-206-4042