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NPI Code Detail

MEDICARE: JOANNA HUCKABAY DO

MEDICARE: JOANNA HUCKABAY DO
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
1390200000XStudent in an Organized Health Care Education/Training Program0116039126VA

General Provider Information

NPI Number : 1811749096
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA HUCKABAY DO
Provider Business Mailing Address
First Line : PO BOX 388
Second Line :
City : FISHERSVILLE
State : VA
Zip : 22939-0388
Country : US
Telephone Number : 540-332-5168
Fax Number : 540-332-5875
Provider Business Practice Location Address
First Line : 78 MEDICAL CENTER CIR
Second Line :
City : FISHERSVILLE
State : VA
Zip : 22939-2272
Country : US
Telephone Number : 540-332-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2024
Last Update Date : 12/18/2024

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