Healthcare Provider Details

I. General information

NPI: 1275587560
Provider Name (Legal Business Name): JOHN EDWARD HUFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334 NW EXPRESSWAY SUITE 214
OKLAHOMA CITY OK
73116-1578
US

IV. Provider business mailing address

4334 NW EXPRESSWAY SUITE 214
OKLAHOMA CITY OK
73116-1578
US

V. Phone/Fax

Practice location:
  • Phone: 405-753-6200
  • Fax: 405-753-6090
Mailing address:
  • Phone: 405-753-6200
  • Fax: 405-753-6090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number13920
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: