MEDICARE: HERBERT JAMES HUSTON PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	085-001637	IL

General Provider Information

NPI Number	:	1942201330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERBERT JAMES HUSTON PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	404 N PLEASANT AVE
Second Line	:
City	:	CENTRALIA
State	:	IL
Zip	:	62801-3006
Country	:	US
Telephone Number	:	618-339-9872
Fax Number	:	618-533-6816

Provider Business Practice Location Address
First Line	:	404 N PLEASANT AVE
Second Line	:
City	:	CENTRALIA
State	:	IL
Zip	:	62801-3006
Country	:	US
Telephone Number	:	618-339-9872
Fax Number	:	618-533-6816

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/15/2013

Similar Medicare Providers

1053350173 — GEORGE SUN MD
Practice Location Address:

430 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-8350
Practice Fax: 618-532-9347

1356449284 — MR. DAVID RUGOWSKI LCPC
Practice Location Address:

444 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-8000
Practice Fax: 618-241-3848

1285733386 — MS. SHARON REED LCPC
Practice Location Address:

444 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-8000
Practice Fax: 618-241-3848

1932208030 — MR. KEITH JOHNSON LCPC
Practice Location Address:

444 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-8000
Practice Fax: 618-241-3848

1558579755 — DR. ROBERT MITCHELL NORMAN MD
Practice Location Address:

444 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-5665
Practice Fax:

1386815959 — STACY D MENEES FNP
Practice Location Address:

432 N PLEASANT AVE
CENTRALIA, IL
62801-3006

Practice Phone: 618-436-8300
Practice Fax:

Directions to “ HERBERT JAMES HUSTON PHYSICIAN ASSISTANT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.