Individual
DR. JASON M HUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-3270
(217) 383-4116
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
269667
NY
2085N0700X
Neuroradiology Physician
269667
NY
2085R0202X
Diagnostic Radiology Physician
Primary
036139273
IL
2085R0202X
Diagnostic Radiology Physician
55374
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03583575
—
NY
Enumeration date
06/15/2008
Last updated
08/06/2016
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