Provider Demographics
NPI:1215908330
Name:OMAHA THORACIC & CARDIOVASCULAR SURGERY, P.C.
Entity type:Organization
Organization Name:OMAHA THORACIC & CARDIOVASCULAR SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANGDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-399-9990
Mailing Address - Street 1:9850 NICHOLAS ST
Mailing Address - Street 2:250
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2186
Mailing Address - Country:US
Mailing Address - Phone:402-399-9990
Mailing Address - Fax:402-399-9851
Practice Address - Street 1:9850 NICHOLAS ST
Practice Address - Street 2:250
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2186
Practice Address - Country:US
Practice Address - Phone:402-399-9990
Practice Address - Fax:402-399-9851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0544098Medicaid
NE07684OtherNE GROUP BCBS
IA43491OtherIA GROUP BCBS
NE50278OtherRAILROAD
NE07684OtherNE GROUP BCBS
NE50278OtherRAILROAD
IA57716Medicare PIN