MEDICARE: DR. KEITH T HUFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	01028609A	IN
2	208D00000X	General Practice Physician	01028609A	IN
3	174400000X	Specialist	01028609A	IN

General Provider Information

NPI Number	:	1073517744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH T HUFF MD

Provider Business Mailing Address
First Line	:	PO BOX 314
Second Line	:
City	:	FRANKLIN
State	:	IN
Zip	:	46131-0314
Country	:	US
Telephone Number	:	317-346-6176
Fax Number	:	317-736-3548

Provider Business Practice Location Address
First Line	:	8244 E US HIGHWAY 36 STE 1100
Second Line	:
City	:	AVON
State	:	IN
Zip	:	46123-9627
Country	:	US
Telephone Number	:	317-272-7500
Fax Number	:	317-272-7515

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	03/19/2021

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