Healthcare Provider Details

I. General information

NPI: 1710551908
Provider Name (Legal Business Name): ALEXANDER HUFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX HUFF

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 HIGHWAY 11 S
POPLARVILLE MS
39470-2625
US

IV. Provider business mailing address

PO BOX 15722
HATTIESBURG MS
39404-5722
US

V. Phone/Fax

Practice location:
  • Phone: 601-403-8284
  • Fax: 601-403-8283
Mailing address:
  • Phone: 601-288-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30375
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: