Provider Demographics
NPI:1588835052
Name:DR DOUGLAS A HUFF
Entity Type:Organization
Organization Name:DR DOUGLAS A HUFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-425-2605
Mailing Address - Street 1:210 N CHESTNUT ST
Mailing Address - Street 2:PO BOX 459
Mailing Address - City:BARNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43713-1248
Mailing Address - Country:US
Mailing Address - Phone:740-425-2605
Mailing Address - Fax:740-425-3158
Practice Address - Street 1:210 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1248
Practice Address - Country:US
Practice Address - Phone:740-425-2605
Practice Address - Fax:740-425-3158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
277-42-2919-001OtherMEDICAL MUTUAL
0400600001OtherADMINISTAR
000000118497OtherANTHEM
OH0487549Medicaid
0400600001OtherADMINISTAR