Provider Demographics
NPI:1407517675
Name:HUMSTON, DAVID PAUL
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:HUMSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199A KENDALL RD
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8695
Mailing Address - Country:US
Mailing Address - Phone:740-981-0042
Mailing Address - Fax:
Practice Address - Street 1:1406 11TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4247
Practice Address - Country:US
Practice Address - Phone:866-534-2639
Practice Address - Fax:800-480-7578
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty