Individual
DAVID J. HUDDLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304
(615) 221-4400
Mailing address
5301 VIRGINIA WAY STE 300, BRENTWOOD, TN 37027-7542
(615) 221-4400
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036092804
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2019-0237
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360928042
—
IL
01
—
220026797
RR MCR
IL
Enumeration date
03/30/2006
Last updated
08/05/2019
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