Provider Demographics
NPI:1104903194
Name:HUFFSTUTLER, RODNEY DALE (DC NP-C)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:DALE
Last Name:HUFFSTUTLER
Suffix:
Gender:M
Credentials:DC NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 COLONNADE PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2342
Mailing Address - Country:US
Mailing Address - Phone:205-971-3356
Mailing Address - Fax:
Practice Address - Street 1:1021 MONTGOMERY HWY STE 201
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2805
Practice Address - Country:US
Practice Address - Phone:205-971-1925
Practice Address - Fax:205-971-1926
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1587111N00000X
AL1-149036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51074878OtherBC/BS PROVIDER NUMBER
AL52691Medicare UPIN
AL74878Medicare ID - Type Unspecified