Provider Demographics
NPI:1275274987
Name:HUFF, ROSS R (DO)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:R
Last Name:HUFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15998 N SHELBY RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:61542-8810
Mailing Address - Country:US
Mailing Address - Phone:309-313-3424
Mailing Address - Fax:
Practice Address - Street 1:636 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2668
Practice Address - Country:US
Practice Address - Phone:239-424-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program