Provider Demographics
NPI:1104037621
Name:HUDDLESTON, STEPHEN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAMES
Last Name:HUDDLESTON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:920 E 1ST ST
Mailing Address - Street 2:STE. P303
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2201
Mailing Address - Country:US
Mailing Address - Phone:218-249-6050
Mailing Address - Fax:218-240-6055
Practice Address - Street 1:920 E 1ST ST
Practice Address - Street 2:STE. P303
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2201
Practice Address - Country:US
Practice Address - Phone:218-249-6050
Practice Address - Fax:218-240-6055
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2013-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN46209208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery