1275520116 NPI number — HUFFMAN AND HUFFMAN PSC

Table of content: (NPI 1275520116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275520116 NPI number — HUFFMAN AND HUFFMAN PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUFFMAN AND HUFFMAN PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275520116
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
503 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40741-1217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-877-1877
Provider Business Mailing Address Fax Number:
606-878-9543

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40741-1217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-877-1877
Provider Business Practice Location Address Fax Number:
606-878-9543
Provider Enumeration Date:
10/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HUFFMAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
GLENN
Authorized Official Title or Position:
CO-PRESIDENT
Authorized Official Telephone Number:
606-877-1877

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 65928822 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77902260 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77903656 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1275520116 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4032919 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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