Provider Demographics
NPI:1447244199
Name:HUFFMAN, JOHN C (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SMITH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4914
Mailing Address - Country:US
Mailing Address - Phone:252-535-8240
Mailing Address - Fax:252-535-8794
Practice Address - Street 1:250 SMITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4914
Practice Address - Country:US
Practice Address - Phone:252-535-8240
Practice Address - Fax:252-535-8794
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39620207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10297OtherBCBSNC
NC1572907OtherCIGNA HEALTHCARE
NC89130GWMedicaid
NC930042520OtherRAILROAD MEDICARE
NCD7881OtherMEDCSOT
NC1572907OtherCIGNA HEALTHCARE
NC2154736AMedicare PIN