Provider Demographics
NPI:1407820129
Name:HUFFMAN, JEFFERY CLIFTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:CLIFTON
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-6300
Mailing Address - Fax:617-726-9946
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:WRN 605
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-6300
Practice Address - Fax:617-726-9946
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21000742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA210074OtherTUFTS HEALTH PLAN
MA2014963Medicaid
MAJ26430OtherBCBS MA
MAJ26430OtherBCBS MA
MAA33563Medicare ID - Type Unspecified