Provider Demographics
NPI:1437117009
Name:HUFF, JAMES COLEMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:COLEMAN
Last Name:HUFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 BANKHEAD HWY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-1962
Mailing Address - Country:US
Mailing Address - Phone:770-832-6272
Mailing Address - Fax:770-832-1028
Practice Address - Street 1:702 BANKHEAD HWY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-1962
Practice Address - Country:US
Practice Address - Phone:770-832-6272
Practice Address - Fax:770-832-1028
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000907152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0233880001Medicare NSC
GAT97665Medicare PIN
GA0233880001Medicare PIN