Provider Demographics
NPI:1366585176
Name:HUFFORD, STEVEN (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:HUFFORD
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 1:225 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-1202
Mailing Address - Country:US
Mailing Address - Phone:231-582-9933
Mailing Address - Fax:231-582-1155
Practice Address - Street 1:225 STATE ST
Practice Address - Street 2:
Practice Address - City:BOYNE CITY
Practice Address - State:MI
Practice Address - Zip Code:49712-1202
Practice Address - Country:US
Practice Address - Phone:231-582-9933
Practice Address - Fax:231-582-1155
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003206152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI942809340Medicaid
MI383122003OtherEYE MED
NJ383122003OtherHORIZON BLUE
MI383122003OtherVSP
MI900A56544OtherBLUE CROSS BLUE SHIELD
MI942809340Medicaid
MI383122003OtherEYE MED
MIU18502Medicare UPIN