Provider Demographics
NPI:1437364445
Name:HUFF, DANIEL J (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HUFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 N GATEWAY DR STE 801
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9004
Mailing Address - Country:US
Mailing Address - Phone:435-787-1023
Mailing Address - Fax:435-787-1882
Practice Address - Street 1:435 N GATEWAY DR STE 801
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9004
Practice Address - Country:US
Practice Address - Phone:435-787-1023
Practice Address - Fax:435-787-1882
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59497580501213E00000X
UT5949758-0501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1437364445Medicaid
UT000061387Medicare PIN
UT6057670002Medicare NSC