Provider Demographics
NPI:1841233566
Name:HUYETTE, JOHN N (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:N
Last Name:HUYETTE
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 210
Mailing Address - Street 2:38 SPRINGFIELD RD
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018
Mailing Address - Country:US
Mailing Address - Phone:610-622-2505
Mailing Address - Fax:610-622-6708
Practice Address - Street 1:38 SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:ALDAN
Practice Address - State:PA
Practice Address - Zip Code:19018
Practice Address - Country:US
Practice Address - Phone:610-622-2505
Practice Address - Fax:610-622-6708
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA025893E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0315169001OtherKEYSTONE HEALTH PLAN EAST
075583OtherBC BS
460963OtherAETNA
B35314Medicare UPIN
0315169001OtherKEYSTONE HEALTH PLAN EAST