Individual
DR. JOHN W HSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E PENNSYLVANIA AVE, SUITE 212, PEORIA, IL 61603-3089
(309) 676-8123
(309) 676-8455
Mailing address
200 E PENNSYLVANIA AVE, SUITE 212, PEORIA, IL 61603-3089
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
036129902
IL
204F00000X
Transplant Surgery Physician
43890
AZ
208600000X
Surgery Physician
MD433479
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102548086
—
PA
01
—
202466
MEDICARE PTAN
—
05
—
569040
—
AZ
Enumeration date
04/24/2007
Last updated
10/04/2012
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