Healthcare Provider Details

I. General information

NPI: 1588739817
Provider Name (Legal Business Name): RONALD G. HUFFMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2259 S 9TH ST
SALINA KS
67401-7313
US

IV. Provider business mailing address

2259 S 9TH ST
SALINA KS
67401-7313
US

V. Phone/Fax

Practice location:
  • Phone: 785-823-2889
  • Fax: 785-823-3507
Mailing address:
  • Phone: 785-823-2889
  • Fax: 785-823-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number969-2
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: