Provider Demographics
NPI:1255360467
Name:HUENE, DOUGLAS B (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:B
Last Name:HUENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1129
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1129
Mailing Address - Country:US
Mailing Address - Phone:970-874-2470
Mailing Address - Fax:
Practice Address - Street 1:296 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2273
Practice Address - Country:US
Practice Address - Phone:970-874-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33382207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841285392001OtherROCKY MOUNTAIN HEALTH PLA
CO01333822Medicaid
COHU43931OtherBCBS
CO200043617Medicare PIN
CO841285392001OtherROCKY MOUNTAIN HEALTH PLA
CO01333822Medicaid
COC462268Medicare PIN