Healthcare Provider Details

I. General information

NPI: 1578097630
Provider Name (Legal Business Name): REBEKAH HUFFMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2017
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
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: 606-877-0082
Mailing address:
  • Phone: 606-877-1877
  • Fax: 606-877-0082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number05183
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS22129
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number75546
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: