Provider Demographics
NPI:1245363795
Name:HUFF, MICHAEL D (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:HUFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 POLK ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71052-2525
Mailing Address - Country:US
Mailing Address - Phone:318-872-9200
Mailing Address - Fax:318-871-8568
Practice Address - Street 1:1126 POLK ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:LA
Practice Address - Zip Code:71052-2525
Practice Address - Country:US
Practice Address - Phone:318-872-9200
Practice Address - Fax:318-871-8568
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA794111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1953300Medicaid
LA1953300Medicaid