Provider Demographics
NPI:1033417902
Name:HUFFMAN, RICHARD LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOUIS
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-3011
Mailing Address - Country:US
Mailing Address - Phone:405-735-2744
Mailing Address - Fax:
Practice Address - Street 1:9101 S WESTERN AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2758
Practice Address - Country:US
Practice Address - Phone:405-735-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKAAA0393Medicare PIN