Healthcare Provider Details

I. General information

NPI: 1205078219
Provider Name (Legal Business Name): MR. PAUL WAYNE HUFFER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 SUMMERTREE LN
LAWRENCE KS
66049-1830
US

IV. Provider business mailing address

214 SUMMERTREE LN
LAWRENCE KS
66049-1830
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-3132
  • Fax:
Mailing address:
  • Phone: 785-841-3132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3-05051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: