Provider Demographics
NPI:1053459354
Name:HUEDO DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:HUEDO DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-283-1003
Mailing Address - Street 1:100 W SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-1716
Mailing Address - Country:US
Mailing Address - Phone:423-283-1003
Mailing Address - Fax:423-283-1007
Practice Address - Street 1:2020 NORTHPARK DR
Practice Address - Street 2:SUITE 1C
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-3100
Practice Address - Country:US
Practice Address - Phone:423-283-1003
Practice Address - Fax:423-283-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3790931Medicare ID - Type Unspecified