Provider Demographics
NPI:1063461523
Name:HUFFMAN, JOHN CHRISTOPHER (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5835
Mailing Address - Country:US
Mailing Address - Phone:412-288-0885
Mailing Address - Fax:412-281-1926
Practice Address - Street 1:1835 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5835
Practice Address - Country:US
Practice Address - Phone:412-288-0885
Practice Address - Fax:412-281-1926
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG001145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016938200001Medicaid
PA0016938200001Medicaid
U01961Medicare UPIN