MEDICARE: DONALD JOHN HUANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	26201	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	11030161	OTHER		CAQH
3	26201	OTHER	AZ	ARIZONA MEDICAL BOARD

General Provider Information

NPI Number	:	1124017595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD JOHN HUANG MD

Provider Business Mailing Address
First Line	:	PO BOX 10880
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86304-0880
Country	:	US
Telephone Number	:	602-406-4786
Fax Number	:	916-636-4358

Provider Business Practice Location Address
First Line	:	3262 N WINDSONG DR BLDG 2
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-2255
Country	:	US
Telephone Number	:	928-771-4788
Fax Number	:	928-771-5712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	03/17/2025

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Directions to “ DONALD JOHN HUANG MD” Practice Location

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