SAM W. HUDDLESTON IV MD PC (NPI# 1649641200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649641200 |
| Entity Type | Organization |
| Organization Name | SAM W. HUDDLESTON IV MD PC |
| Practice Address |
2002 Brookside Dr Suite# 201 Kingsport TN 37660-4634 |
| Practice Telephone | 4232457080 |
| Practice Fax Number | 4232457875 |
| Mailing Telephone | 4232457080 |
| Mailing Fax Number | 4232457875 |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |
| Authorized Official Name | DR. SAM W HUDDLESTON (OWNER) |
| Authorized Official Telephone | 4232457080 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD15029 | TN | Other Service Providers |
| Street Address |
2002 BROOKSIDE DR SUITE# 201 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293560 | Nicole M Miller | Pediatrics | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2005-05-27 |
| 1487050233 | Natasha Benfield Gouge | Psychologist | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2014-11-06 |
| 1992105431 | Bblue Ridge Medical Management Corporation | Pediatrics | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2014-09-03 |
| 1659706208 | Ashley H Begley | Nurse Practitioner | 2002 Brookside Dr, Kingsport, TN 37660-4634 | 2013-09-13 |
| 1346686763 | Blue Ridge Medical Management Corporation | Specialist | 2002 Brookside Dr, Suite 300a, Kingsport, TN 37660-4634 | 2013-05-13 |
| 1538378005 | Janice Louise Yeager | Registered Nurse | 2002 Brookside Dr, Suite 300, Kingsport, TN 37660-4634 | 2007-05-22 |
| 1639210222 | Sathiyendran Poobalasingham | Internal Medicine | 2002 Brookside Dr, Suite 102, Kingsport, TN 37660-4634 | 2007-02-08 |
| 1902918717 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 2002 Brookside Dr, Suite 101, Kingsport, TN 37660-4634 | 2006-08-31 |
| 1659382885 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2006-08-11 |
| 1548270879 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 2002 Brookside Dr, Ste 300, Kingsport, TN 37660-4634 | 2006-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391012 | Chelsey Bishop | Specialist | 400 Blue Haven Dr, Kingsport, TN 37663-3043 | 2017-04-23 |
| 1326397910 | Simpson Clinic, LLC | Specialist | 2012 Brookside Drive, Suite 8, Kingsport, TN 37660 | 2012-08-29 |
| 1639343734 | K. G. Porter, Md, LLC | Specialist | 1936 Brookside Dr Ste C, Kingsport, TN 37660-4654 | 2008-04-18 |
| 1760593834 | Premier Anesthesia Services PC | Specialist | 2000 Brookside Drive, Suite 207, Kingsport, TN 37660-4627 | 2006-08-31 |
| 1043228646 | Randall J Falconer Md PC | Specialist | 1728 N Eastman Road, Kingsport, TN 37664 | 2006-08-03 |
| 1235197815 | W Jan Kazmier | Specialist | 2995 Fort Henry Dr, Suite 100, Kingsport, TN 37664-4005 | 2006-05-03 |
| 1346686763 | Blue Ridge Medical Management Corporation | Specialist | 2002 Brookside Dr, Suite 300a, Kingsport, TN 37660-4634 | 2013-05-13 |
| 1730395153 | Donna Howard Crotts | Specialist | 130 W Ravine Rd, Kingsport, TN 37660-3810 | 2007-05-15 |
| 1932312337 | Heather Christine Wallen | Specialist | 1041 East Sullivan Street, Kingsport, TN 37660 | 2007-05-08 |
| 1073638144 | Regional Kidney Care, PC | Specialist | 2002 Brookside Drive, Suite 102, Kingsport, TN 37660-4634 | 2007-03-20 |
| Find all providers in KINGSPORT | ||||
Please comment or provide details below to improve the information on SAM W. HUDDLESTON IV MD PC.
| 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.