Provider Demographics
NPI:1073547584
Name:HUFF, DOUGLES LEE (PA)
Entity Type:Individual
Prefix:
First Name:DOUGLES
Middle Name:LEE
Last Name:HUFF
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801W 81ST ST 108
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1111
Mailing Address - Country:US
Mailing Address - Phone:952-837-9700
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1D
Practice Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-273-6004
Practice Address - Fax:612-273-8459
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9087363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-10163OtherMEDICA PRIMARY
MN01-13423OtherMEDICA CHOICE
MNHP39022OtherHEALTHPARTNERS
MN220599800Medicare ID - Type UnspecifiedMN MA