Provider Demographics
NPI:1588739817
Name:HUFFMAN, RONALD G (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
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 1:2259 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7313
Mailing Address - Country:US
Mailing Address - Phone:785-823-2889
Mailing Address - Fax:785-823-3507
Practice Address - Street 1:2259 S 9TH ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7313
Practice Address - Country:US
Practice Address - Phone:785-823-2889
Practice Address - Fax:785-823-3507
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS969-2152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST91614Medicare UPIN
KS49669Medicare ID - Type Unspecified