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General NPI Number Information
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NPI Number | 1013391317
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Entity Type | Organization
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Legal Business Name | HUGGINS MEDICAL GROUP, PC
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 6934 BROAD ST
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1604
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Country | US
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Telephone | 770-702-7728
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Fax | 770-726-7265
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Provider Business Mailing Address
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Address Line | 6934 BROAD ST
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-1604
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Country | US
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Telephone | 770-702-7728
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Fax | 770-726-7265
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MICHELLE ALLISON HUGGINS
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Credential | MD
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Telephone | 770-702-7728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 034368
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License Number State | GA
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