Healthcare Provider Details

I. General information

NPI: 1588835052
Provider Name (Legal Business Name): DR DOUGLAS A HUFF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N CHESTNUT ST
BARNESVILLE OH
43713-1248
US

IV. Provider business mailing address

210 N CHESTNUT ST PO BOX 459
BARNESVILLE OH
43713-1248
US

V. Phone/Fax

Practice location:
  • Phone: 740-425-2605
  • Fax: 740-425-3158
Mailing address:
  • Phone: 740-425-2605
  • Fax: 740-425-3158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS A HUFF
Title or Position: OWNER
Credential: OD
Phone: 740-425-2605