Healthcare Provider Details

I. General information

NPI: 1467547190
Provider Name (Legal Business Name): LAWRENCE ROBERT HUFFORD D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 MAIN ST
HAMILTON OH
45013-4717
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-863-8798
  • Fax: 513-863-7648
Mailing address:
  • Phone: 513-863-8798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2238
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: