Healthcare Provider Details

I. General information

NPI: 1487681383
Provider Name (Legal Business Name): GAREY H HUFF SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 W CANDLER ST
WINDER GA
30680-2558
US

IV. Provider business mailing address

PO BOX 742616
ATLANTA GA
30374-2616
US

V. Phone/Fax

Practice location:
  • Phone: 770-867-4541
  • Fax: 770-867-2583
Mailing address:
  • Phone: 770-219-8420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17665
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: