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General NPI Number Information
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NPI Number | 1922270156
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Entity Type | Individual
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Provider Name | DAVID HUDDLESTON
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Gender | Male
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 153 PIONEER LN
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City | BISHOP
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State | CA
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Zip | 93514-2517
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Country | US
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Telephone | 760-872-1606
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-1178
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME166205
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A128064
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License Number State | CA
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