Healthcare Provider Details

I. General information

NPI: 1609857192
Provider Name (Legal Business Name): DAVID W. HUFFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 N WEBB RD
WICHITA KS
67206-3405
US

IV. Provider business mailing address

1923 N WEBB RD
WICHITA KS
67206-3405
US

V. Phone/Fax

Practice location:
  • Phone: 316-262-4886
  • Fax: 316-262-4887
Mailing address:
  • Phone: 316-262-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number04-20563
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20563
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number04-20563
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number04-20563
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-20563
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: