MEDICARE: JANICE BUTCHER HUCKABY M.D.

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	207VH0002X	Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician	MD31089	TN

General Provider Information

NPI Number	:	1982827515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE BUTCHER HUCKABY M.D.

Provider Business Mailing Address
First Line	:	10 CADILLAC DR
Second Line	:	SUITE 200
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5078
Country	:	US
Telephone Number	:	615-372-3622
Fax Number	:	813-372-3640

Provider Business Practice Location Address
First Line	:	10 CADILLAC DR
Second Line	:	SUITE 200
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5078
Country	:	US
Telephone Number	:	615-372-3622
Fax Number	:	813-372-3640

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	11/03/2008

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