Provider Demographics
NPI:1821600164
Name:HUFF, BILLY RAY JR (CRT,RCP)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:RAY
Last Name:HUFF
Suffix:JR
Gender:M
Credentials:CRT,RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-7034
Mailing Address - Country:US
Mailing Address - Phone:405-915-4400
Mailing Address - Fax:
Practice Address - Street 1:134 N PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-7034
Practice Address - Country:US
Practice Address - Phone:405-915-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist