Provider Demographics
NPI:1477509461
Name:HUXOL, ROBERT F (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:HUXOL
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 1:3525 GIRL SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:KY
Mailing Address - Zip Code:42376-9321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 POWELL STREET
Practice Address - Street 2:SUITE 920
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1803
Practice Address - Country:US
Practice Address - Phone:510-350-2600
Practice Address - Fax:510-597-9200
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02387207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64023872Medicaid
KY64023872Medicaid
KYE26597Medicare UPIN