1588835052 NPI number — DR DOUGLAS A HUFF

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588835052 NPI number — DR DOUGLAS A HUFF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR DOUGLAS A HUFF
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:
1588835052
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 N CHESTNUT ST
Provider Second Line Business Mailing Address:
PO BOX 459
Provider Business Mailing Address City Name:
BARNESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43713-1248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-425-2605
Provider Business Mailing Address Fax Number:
740-425-3158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 N CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARNESVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43713-1248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-425-2605
Provider Business Practice Location Address Fax Number:
740-425-3158
Provider Enumeration Date:
03/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HUFF
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
740-425-2605

Provider Taxonomy Codes

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

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

  • Identifier: 277-42-2919-001 . This is a "MEDICAL MUTUAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0400600001 . This is a "ADMINISTAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000118497 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0487549 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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