Healthcare Provider Details

I. General information

NPI: 1699703157
Provider Name (Legal Business Name): GEORGE RUSSELL HUFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 N LAKEMONT AVE STE 207
WINTER PARK FL
32792-3219
US

IV. Provider business mailing address

833 CHESTNUT ST STE 520
PHILADELPHIA PA
19107-4430
US

V. Phone/Fax

Practice location:
  • Phone: 407-852-5333
  • Fax: 407-743-3050
Mailing address:
  • Phone: 609-677-7003
  • Fax: 267-339-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD424496
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME152386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: