Healthcare Provider Details

I. General information

NPI: 1447244199
Provider Name (Legal Business Name): JOHN C HUFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 SMITH CHURCH RD
ROANOKE RAPIDS NC
27870-4914
US

IV. Provider business mailing address

250 SMITH CHURCH RD
ROANOKE RAPIDS NC
27870-4914
US

V. Phone/Fax

Practice location:
  • Phone: 252-535-8240
  • Fax: 252-535-8794
Mailing address:
  • Phone: 252-535-8240
  • Fax: 252-535-8794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number39620
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: