Individual
PRESTON HUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19874
OK
207R00000X
Internal Medicine Physician
Primary
19874
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253710D
—
OK
01
—
100699880C
RHC GROUP MEDICAID NUMBER
OK
01
—
373994
GROUP RHC MEDICARE NUMBER
OK
01
—
H37015401
HGH GROUP MEDICARE NUMBER
OK
Enumeration date
07/25/2006
Last updated
09/14/2016
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