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General NPI Number Information
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NPI Number | 1043625635
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Entity Type | Individual
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Provider Name | ERIC HUCKINS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 1313 FISH HATCHERY RD
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City | MADISON
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State | WI
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Zip | 53715-1911
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Country | US
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Telephone | 608-294-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 725 UNIVERSITY ROW APT 202
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City | MADISON
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State | WI
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Zip | 53705-1447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17439-40
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License Number State | WI
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