Provider Demographics
NPI:1316973563
Name:HUSTON, DONALD CARL JR (DO)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CARL
Last Name:HUSTON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1120 DELSEA DR N FL 2
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1444
Mailing Address - Country:US
Mailing Address - Phone:856-595-9136
Mailing Address - Fax:856-575-5097
Practice Address - Street 1:1120 DELSEA DR N FL 2
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1444
Practice Address - Country:US
Practice Address - Phone:856-595-9136
Practice Address - Fax:856-575-5097
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB47363207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1217003Medicaid
NJE53380Medicare UPIN
NJ1217003Medicaid