Doctor Name: | DR. ERICA HUDDLESTON |
NPI Number: | 1003127010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 11015739A |
Business Practice Address: | 7910 E Washington St Suite 200 Indianapolis, IN - 462196803 |
Business Phone Number: | 3173557171 |
Business Fax Number: | 3173559022 |
Mailing Address: | 6626 E. 75th Street, Suite 500 INDIANAPOLIS |
State: | IN |
Postal Code: | 462502890 |
Phone Number: | 3173557199 |
Fax Number: | 3173559022 |
NPI Enumeration Date: | 06/24/2010 |
NPI Last Update Date: | 03/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 11015739A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |