Healthcare Provider Details

I. General information

NPI: 1780687897
Provider Name (Legal Business Name): MILFORD J HUFFNAGLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 HIGHWAY 46 S
DICKSON TN
37055-2556
US

IV. Provider business mailing address

113 HIGHWAY 70 E
DICKSON TN
37055-2080
US

V. Phone/Fax

Practice location:
  • Phone: 615-441-4404
  • Fax: 615-446-1357
Mailing address:
  • Phone: 615-446-5121
  • Fax: 615-446-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD27762
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: