SAMUEL W HUDDLESTON IV (NPI# 1770508525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770508525 |
Entity Type | Individual |
Full Name | SAMUEL W HUDDLESTON IV |
Credential | MD |
Practice Address |
2002 Brookside Drive Ste 201 Kingsport TN 37660 |
Practice Telephone | 4232457080 |
Practice Fax Number | 4232457875 |
Mailing Telephone | 4232457080 |
Mailing Fax Number | 4232457875 |
Enumeration Date | 2006-07-13 |
Last Update Date | 2013-12-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
15029 | TN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ANTHEM | 384053 | 01 | |
AETNA | 5331096 | 01 | |
BCBS | 0070707 | 01 | |
LIC | 15029 | 01 | |
TN | 3032417 | 05 | |
DEA | AH239412 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851992317 | Samuel Blake Huddleston | Physical Therapist | 1932 Almaville Rd Ste 115, Smyrna, TN 37167-7600 | 2020-11-02 |
1801139423 | Samuel Fielding Huddleston | Emergency Medicine | 3280 Joe Battle Blvd, El Paso, TX 79938-2622 | 2013-04-02 |
1053607432 | Samuel Winston Huddleston V | Radiology | 408 N State of Franklin Rd, Suite 31, Johnson City, TN 37604-6089 | 2011-06-23 |
Street Address |
2002 BROOKSIDE DRIVE STE 201 |
City | KINGSPORT |
State | TN |
Zip Code | 37660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073638144 | Regional Kidney Care, PC | Specialist | 2002 Brookside Drive, Suite 102, Kingsport, TN 37660-4634 | 2007-03-20 |
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 | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841433059 | New Horizons Plastic Surgery LLC | Surgery | 2033 Meadowview Ln, Suite 110, Kingsport, TN 37660-7569 | 2009-04-17 |
1912178112 | Kingsport Plastic Surgery, PC | Surgery | 2012 Brookside Dr, Suite 1, Kingsport, TN 37660-4645 | 2008-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255829552 | Ahmed Al Bayati | Surgery | Medical Center North 1161 21st Avenue S Suite Ccc-4312, Nashville, TN 37232-0001 | 2018-04-23 |
1275039661 | Mekia Truclaye Kauffman | Surgery | 1934 Alcoa Hwy Ste D-362, Knoxville, TN 37920-1524 | 2018-04-04 |
1497137574 | Daniel A Hatef Md, Pllc | Surgery | 6200 Highway 100 Ste 101, Nashville, TN 37205-4252 | 2015-06-24 |
1336588201 | Nashville Plastic and Reconstructive Surgery, Plc | Surgery | 2201 Murphy Ave Ste 301, Nashville, TN 37203-1956 | 2013-06-24 |
1851657597 | Jordi Puente Espel | Surgery | 6215 Humphreys Blvd Ste 103, Memphis, TN 38120-2382 | 2012-04-06 |
1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
1942500319 | Sieveking Plastic Surgery | Surgery | 204 23rd Ave N, Nashville, TN 37203-1502 | 2010-11-01 |
1275733081 | Natasha Nicole Luckey | Surgery | 2001 Mallory Ln Ste 205, Franklin, TN 37067-8235 | 2007-07-19 |
1841406063 | Robert F Garza | Surgery | 4322 Harding Rd, Suite 326, Nashville, TN 37205-2490 | 2007-05-15 |
1558583021 | Stewart Charles Little | Surgery | 2358 Lifestyle Way Ste 212, Chattanooga, TN 37421-2291 | 2007-05-03 |
Find all providers with the same taxonomy |
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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.