Provider Demographics
NPI:1972667632
Name:HUNTINGTON, JOANNE IRBY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:IRBY
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1668
Mailing Address - Street 2:
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-1668
Mailing Address - Country:US
Mailing Address - Phone:970-349-7193
Mailing Address - Fax:866-245-3787
Practice Address - Street 1:309 SIXTH STREET
Practice Address - Street 2:UNIT A
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81224
Practice Address - Country:US
Practice Address - Phone:970-349-7193
Practice Address - Fax:866-245-3787
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO45619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO139345Medicaid
CO139345Medicaid