Provider Demographics
NPI:1255349155
Name:HUFFER, RANDALL WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:WILLIAM
Last Name:HUFFER
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 1:9383 S OLD STATE RD
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8448
Mailing Address - Country:US
Mailing Address - Phone:614-846-2225
Mailing Address - Fax:614-846-8300
Practice Address - Street 1:9383 S OLD STATE RD
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035
Practice Address - Country:US
Practice Address - Phone:614-846-2225
Practice Address - Fax:614-846-8300
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4122941Medicare PIN
U47930Medicare UPIN