Provider Demographics
NPI:1073020558
Name:HUFFMAN, JOHN EMERSON II
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EMERSON
Last Name:HUFFMAN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:S BLOOMFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43103-9002
Mailing Address - Country:US
Mailing Address - Phone:614-403-8072
Mailing Address - Fax:
Practice Address - Street 1:3042 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3653
Practice Address - Country:US
Practice Address - Phone:614-487-7805
Practice Address - Fax:614-487-7809
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-16-22188106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician