Provider Demographics
NPI:1457528028
Name:PADUSSIS, JAMES CONSTANTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CONSTANTINE
Last Name:PADUSSIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:EMILE 42ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-0001
Mailing Address - Country:US
Mailing Address - Phone:402-559-4500
Mailing Address - Fax:402-559-9416
Practice Address - Street 1:EMILE 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-559-4500
Practice Address - Fax:402-559-9416
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC128755208600000X
NE287652086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery