Provider Demographics
NPI:1710129671
Name:HEART LUNG AND VASCULAR SURGERY PC
Entity Type:Organization
Organization Name:HEART LUNG AND VASCULAR SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FELDHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-393-6700
Mailing Address - Street 1:7710 MERCY RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2372
Mailing Address - Country:US
Mailing Address - Phone:402-393-6700
Mailing Address - Fax:402-393-1098
Practice Address - Street 1:210 RIDGE
Practice Address - Street 2:JENNIE EDMUNDSEN HOSPITAL
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:402-393-6700
Practice Address - Fax:402-393-1098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27908174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1399OtherPTAN
IAIB1399OtherPTAN