Provider Demographics
NPI:1982135703
Name:HUFFMAN, TRAVIS R
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:R
Last Name:HUFFMAN
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-331-0774
Mailing Address - Fax:859-578-3800
Practice Address - Street 1:1640 FLOSSIE DR
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:IN
Practice Address - Zip Code:47025-8424
Practice Address - Country:US
Practice Address - Phone:859-331-0774
Practice Address - Fax:859-578-3800
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04760207RC0000X
IN02007291A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease