Provider Demographics
NPI:1093739427
Name:HUSSA, JOHN FLORIAN (MD AODAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FLORIAN
Last Name:HUSSA
Suffix:
Gender:M
Credentials:MD AODAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-3626
Mailing Address - Country:US
Mailing Address - Phone:715-685-5500
Mailing Address - Fax:715-685-5102
Practice Address - Street 1:1615 MAPLE LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-3626
Practice Address - Country:US
Practice Address - Phone:715-685-5500
Practice Address - Fax:715-685-5102
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171692084P0802X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2632839 10OtherM MA
391662030OtherASHLAND CTY
WI31192600Medicaid
0979600000OtherBAYFIELD CTY
0979600000OtherBAYFIELD CTY