Individual
JAMES A SUTPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3410 N 156TH ST, OMAHA, NE 68116-2020
(402) 614-1258
(402) 614-5733
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1218
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38050
BCBS
NE
Enumeration date
07/20/2006
Last updated
12/19/2017
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