Healthcare Provider Details

I. General information

NPI: 1114048394
Provider Name (Legal Business Name): HUFFORD VISION & EYE CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 RIVER STREET
ELK RAPIDS MI
49629
US

IV. Provider business mailing address

PO BOX 517
ELK RAPIDS MI
49629-0517
US

V. Phone/Fax

Practice location:
  • Phone: 231-264-2020
  • Fax: 231-264-9662
Mailing address:
  • Phone: 231-264-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901003206
License Number StateMI

VIII. Authorized Official

Name: DR. STEVEN M. HUFFORD
Title or Position: PRESIDENT
Credential: O.D.
Phone: 231-582-9933