Provider Demographics
NPI:1215074091
Name:FAMILY MEDICINE OF HUNTSVILLE, PC
Entity type:Organization
Organization Name:FAMILY MEDICINE OF HUNTSVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:WM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-539-7722
Mailing Address - Street 1:2410 COMMERCE CT SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5679
Mailing Address - Country:US
Mailing Address - Phone:256-539-7722
Mailing Address - Fax:256-539-1816
Practice Address - Street 1:2410 COMMERCE CT SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5679
Practice Address - Country:US
Practice Address - Phone:256-539-7722
Practice Address - Fax:256-539-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72386Medicare UPIN
ALH15252Medicare UPIN
ALC36416Medicare UPIN
D379Medicare ID - Type Unspecified
ALF93248Medicare UPIN