MEDICARE: DR. JASON HUFFMAN D.C.

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	111N00000X	Chiropractor	038009917	IL

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

General Provider Information

NPI Number	:	1134139207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON HUFFMAN D.C.

Provider Business Mailing Address
First Line	:	1701 SHEPHERD RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-2179
Country	:	US
Telephone Number	:	863-646-5575
Fax Number	:	863-648-4465

Provider Business Practice Location Address
First Line	:	1701 SHEPHERD RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-2179
Country	:	US
Telephone Number	:	863-646-5575
Fax Number	:	863-648-4465

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/26/2013

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