Provider Demographics
NPI:1275587560
Name:HUFF, JOHN EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:HUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4334 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1578
Mailing Address - Country:US
Mailing Address - Phone:405-753-6200
Mailing Address - Fax:405-753-6090
Practice Address - Street 1:4334 NW EXPRESSWAY
Practice Address - Street 2:SUITE 214
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1578
Practice Address - Country:US
Practice Address - Phone:405-753-6200
Practice Address - Fax:405-753-6090
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK13920207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100101240AMedicaid
OKD34835Medicare UPIN