Provider Demographics
NPI:1700889813
Name:HUFFNAGLE, VERA H (MD)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:H
Last Name:HUFFNAGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2855
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1357
Practice Address - Street 1:758 HIGHWAY 46 S
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2556
Practice Address - Country:US
Practice Address - Phone:615-441-4546
Practice Address - Fax:615-441-4583
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD277612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3158160OtherBLUE CROSS BLUE SHIELD TN
TN3807659Medicaid
130022642OtherRAILROAD MEDICARE PIN
F59533Medicare UPIN
3807659Medicare PIN