MATTHEW DAVID HUCKABY (NPI# 1194144824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194144824 |
| Entity Type | Individual |
| Full Name | MATTHEW DAVID HUCKABY |
| Credential | MD |
| Practice Address |
969 Lakeland Drive Emergency Department Jackson MS 39216 |
| Mailing Address |
Po Box 23457 Jackson MS 39225-3457 |
| Practice Telephone | 6012006175 |
| Practice Fax Number | 6012002020 |
| Mailing Telephone | 6012006175 |
| Mailing Fax Number | 6012002020 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2020-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 24709 | MS | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | MD.208248 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08627073 | 05 |
| Street Address |
969 LAKELAND DRIVE EMERGENCY DEPARTMENT |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215934047 | James P Almas | Pathology | 969 Lakeland Drive, Jackson, MS 39216-4699 | 2005-07-07 |
| 1821192204 | Thomas A Rose | Pathology | 969 Lakeland Drive, Jackson, MS 39216-4699 | 2006-09-07 |
| 1760457980 | Randall S Smith | Pathology | 969 Lakeland Drive, Jackson, MS 39216-4699 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891141032 | Tobin S Dennis | Emergency Medicine | 625 East Broadway Ave, Jackson, WY 83001-8642 | 2016-05-06 |
| 1902270093 | Steven Pirtle French | Emergency Medicine | 6605 N Snake River Woods Dr, Jackson, WY 83001-8491 | 2015-11-30 |
| 1942612015 | Emergency Associates Pllc | Emergency Medicine | 2660 Ridgewood Rd, Suite 100, Jackson, MS 39216-4921 | 2014-05-23 |
| 1083995674 | Obhg Mississippi, P.C. | Emergency Medicine | 1225 N State St Ste B1, Jackson, MS 39202-2072 | 2011-09-09 |
| 1508180183 | Jon Edward Zamber | Emergency Medicine | 361 Willie Adams Rd, Jackson, TN 38305-7223 | 2010-03-25 |
| 1750510962 | Jason Robert Schwanebeck | Emergency Medicine | University of Missisippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505 | 2009-07-09 |
| 1366629214 | Joseph Scott Savage | Emergency Medicine | 400 N Alpine Lake Dr, Suite F, Jackson, MI 49203-6334 | 2008-01-23 |
| 1689709610 | Dawn Nicole Laws | Emergency Medicine | 1325 N West Ave, Jackson, MI 49202-2050 | 2007-02-22 |
| 1194834747 | Joseph W Blackston | Emergency Medicine | 1900 Petit Bois St N, Jackson, MS 39211-6707 | 2006-08-29 |
| 1174637318 | Kaushal Patel | Emergency Medicine | 205 Trace Dr, Jackson, TN 38305-1580 | 2006-08-17 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.