Provider Demographics
NPI:1760442370
Name:HUFFMAN, JAMES (PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:71943-9243
Mailing Address - Country:US
Mailing Address - Phone:870-356-4821
Mailing Address - Fax:
Practice Address - Street 1:234 E BROADWAY
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:AR
Practice Address - Zip Code:71943-9243
Practice Address - Country:US
Practice Address - Phone:870-356-4821
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA231363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP25877Medicare UPIN