Healthcare Provider Details
I. General information
NPI: 1710006549
Provider Name (Legal Business Name): HUFFMAN AND HUFFMAN PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2007
Last Update Date: 04/15/2009
Certification Date:
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
- Phone: 606-877-1877
- Fax: 606-878-9543
- Phone: 606-877-1877
- Fax: 606-878-9543
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
GLENN
HUFFMAN
Title or Position: CO-PRESIDENT
Credential: M.D.
Phone: 606-877-1877