Provider Demographics
NPI:1114048394
Name:HUFFORD VISION & EYE CARE, PC
Entity Type:Organization
Organization Name:HUFFORD VISION & EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-582-9933
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:ELK RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49629-0517
Mailing Address - Country:US
Mailing Address - Phone:231-264-2020
Mailing Address - Fax:
Practice Address - Street 1:123 RIVER STREET
Practice Address - Street 2:
Practice Address - City:ELK RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49629
Practice Address - Country:US
Practice Address - Phone:231-264-2020
Practice Address - Fax:231-264-9662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUFFORD VISION & EYE CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-03
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003206152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI942809340Medicaid
MI900A56544OtherBLUE CROSS BLUE SHIELD
NJ=========OtherHORIZON BLUE
MI0M82750Medicare PIN
MI=========OtherVISION SERVICE PLAN
MI900A56544OtherBLUE CROSS BLUE SHIELD