Healthcare Provider Details

I. General information

NPI: 1144240003
Provider Name (Legal Business Name): JASON T HUFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3273 CLAREMONT WAY SUITE 100
NAPA CA
94558-3306
US

IV. Provider business mailing address

3273 CLAREMONT WAY SUITE 100
NAPA CA
94558-3306
US

V. Phone/Fax

Practice location:
  • Phone: 707-254-7117
  • Fax: 707-265-6435
Mailing address:
  • Phone: 707-254-7117
  • Fax: 707-265-6435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA745100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: