Healthcare Provider Details

I. General information

NPI: 1386263713
Provider Name (Legal Business Name): JAMES ROSS HUGGINS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W MAIN ST
BENSON NC
27504-1343
US

IV. Provider business mailing address

113 W MAIN ST
BENSON NC
27504-1343
US

V. Phone/Fax

Practice location:
  • Phone: 919-894-7579
  • Fax: 919-894-4674
Mailing address:
  • Phone: 919-894-7579
  • Fax: 919-894-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2167
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2663
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: