=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962413674
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARL W. HUFF, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2006
-----------------------------------------------------
Last Update Date | 07/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1855 HWY 51 BYPASS SUITE B
-----------------------------------------------------
City | DYERSBURG
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38024-1855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-285-1585
-----------------------------------------------------
Fax | 731-285-1492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 148
-----------------------------------------------------
City | MARTIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38237-0148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-587-5359
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CARL WAYNE HUFF
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 731-587-5359
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | MD006673
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------