Provider Demographics
NPI:1932204658
Name:HUGGINS, EDDIE LEE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:LEE
Last Name:HUGGINS
Suffix:JR
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 1:4616 MCCLELLAN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206
Mailing Address - Country:US
Mailing Address - Phone:256-236-5554
Mailing Address - Fax:256-236-5543
Practice Address - Street 1:4616 MCCLELLAN BOULEVARD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206
Practice Address - Country:US
Practice Address - Phone:256-236-5554
Practice Address - Fax:256-236-5543
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL153152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-88925OtherBC/BS OF AL
AL88925Medicaid
AL515-07862OtherBLUE CROSS-FEDERAL
AL88925Medicare ID - Type Unspecified
AL88925Medicaid