Healthcare Provider Details

I. General information

NPI: 1609294495
Provider Name (Legal Business Name): LAUREN HUCKABY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COURTENAY DRIVE DEPARTMENT OF SURGERY
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

30 COURTENAY DRIVE DEPARTMENT OF SURGERY
CHARLESTON SC
29425-0001
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone: 843-792-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number97271
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: