Healthcare Provider Details

I. General information

NPI: 1205808680
Provider Name (Legal Business Name): KALAICHELVI R HUFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALAI R HUFF MD

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MERCY WAY
JOPLIN MO
64804-4524
US

IV. Provider business mailing address

100 MERCY WAY
JOPLIN MO
64804-4524
US

V. Phone/Fax

Practice location:
  • Phone: 417-556-6479
  • Fax: 417-621-0404
Mailing address:
  • Phone: 417-556-6479
  • Fax: 417-621-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberR-3494
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: