Provider Demographics
NPI:1205826989
Name:PFLUG, JOHN W (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:PFLUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 241111
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-5111
Mailing Address - Country:US
Mailing Address - Phone:402-906-0979
Mailing Address - Fax:402-502-3990
Practice Address - Street 1:16929 FRANCES ST
Practice Address - Street 2:SUITE 201 OMAHA EAR, NOSE & THROAT CLINIC
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4683
Practice Address - Country:US
Practice Address - Phone:402-758-5330
Practice Address - Fax:402-758-5339
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18465207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00224OtherBCBS
NE47077661913Medicaid
264345Medicare ID - Type Unspecified
NE47077661913Medicaid
F12413Medicare UPIN