Provider Demographics
NPI:1881241594
Name:HUFFMAN, JEFFREY ALAN (RPH, BCPS)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:RPH, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BRIAR MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CARL JUNCTION
Mailing Address - State:MO
Mailing Address - Zip Code:64834-9787
Mailing Address - Country:US
Mailing Address - Phone:417-483-1058
Mailing Address - Fax:
Practice Address - Street 1:2623 W 7TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-3300
Practice Address - Country:US
Practice Address - Phone:417-206-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0439141835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy