Organization Active NPI

Costas L. Constantinou, M.D., P.C

  • Hematology & Oncology Physician
  • Davenport, IA
National Provider Identifier
1306027164
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
COSTAS L. CONSTANTINOU, M.D., P.C
Practice address
1409 E Kimberly Rd
Davenport, IA 52807-1923
Phone
(563) 359-9876
Fax
(563) 359-0608
NPI assigned
Nov 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Costas L Constantinou, M.D.
Title
President
Phone
(563) 359-9876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

1409 E Kimberly Rd
Davenport, IA 52807-1923

Mailing address

1409 E Kimberly Rd
Davenport, IA 52807-1923
Phone (563) 359-9876

Other identifiers 1

IdentifierTypeStateIssuer
3217588MedicaidIA

National Provider Directory

National Provider Directory

Locations

1409 E Kimberly Rd
Davenport, IA 52807
Phone (563) 324-3818

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1306027164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071923",
            "telephone_number": "563-359-9876",
            "fax_number": "563-359-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071923",
            "telephone_number": "563-359-9876",
            "fax_number": "563-359-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTAS L. CONSTANTINOU, M.D., P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "CONSTANTINOU",
        "authorized_official_first_name": "COSTAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-359-9876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3217588",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.