Provider Demographics
NPI:1518086347
Name:HUFFMAN AND HUFFMAN PSC
Entity Type:Organization
Organization Name:HUFFMAN AND HUFFMAN PSC
Other - Org Name:OPTOMETRIST GROUP NO
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-679-7461
Mailing Address - Street 1:303 LANGDON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2750
Mailing Address - Country:US
Mailing Address - Phone:606-679-7461
Mailing Address - Fax:606-679-8202
Practice Address - Street 1:303 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2750
Practice Address - Country:US
Practice Address - Phone:606-679-7461
Practice Address - Fax:606-679-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77903656Medicaid