Healthcare Provider Details

I. General information

NPI: 1275520116
Provider Name (Legal Business Name): HUFFMAN AND HUFFMAN PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N MAIN ST
LONDON KY
40741-1217
US

IV. Provider business mailing address

503 N MAIN ST
LONDON KY
40741-1217
US

V. Phone/Fax

Practice location:
  • Phone: 606-877-1877
  • Fax: 606-878-9543
Mailing address:
  • Phone: 606-877-1877
  • Fax: 606-878-9543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES GLENN HUFFMAN
Title or Position: CO-PRESIDENT
Credential: MD
Phone: 606-877-1877