Provider Demographics
NPI:1336213024
Name:HUFFMAN, WILLIAM LEE (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-5008
Mailing Address - Country:US
Mailing Address - Phone:717-272-5881
Mailing Address - Fax:717-272-3866
Practice Address - Street 1:40 N 8TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046
Practice Address - Country:US
Practice Address - Phone:717-272-5881
Practice Address - Fax:717-272-3866
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE005601P152W00000X
GAOPT001727152W00000X
OH3243T1658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007995200001Medicaid
232179318OtherFEDTON
PA0007995200001Medicaid
PA0257540001Medicare NSC