Healthcare Provider Details
I. General information
NPI: 1922973932
Provider Name (Legal Business Name): DALTON HUFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
265 S SCATTERFIELD RD
ANDERSON IN
46012-5106
US
IV. Provider business mailing address
265 S SCATTERFIELD RD
ANDERSON IN
46012-5106
US
V. Phone/Fax
- Phone: 765-643-3400
- Fax:
- Phone: 765-643-3400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 26031547A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: