Provider Demographics
NPI:1710006549
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:JAMES
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-877-1877
Mailing Address - Street 1:503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-1217
Mailing Address - Country:US
Mailing Address - Phone:606-877-1877
Mailing Address - Fax:606-878-9543
Practice Address - Street 1:503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1217
Practice Address - Country:US
Practice Address - Phone:606-877-1877
Practice Address - Fax:606-878-9543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77902260Medicaid