Individual
DR. DON M. HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1605 MARTIN SPRINGS DR, STE 110, ROLLA, MO 65401-2982
(573) 458-6610
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
R7B97
MO
2085R0202X
Diagnostic Radiology Physician
Primary
R7B97
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306991336
—
MO
01
—
431560263
TRICARE
MO
01
—
P00154215
RR MCR
MO
Enumeration date
01/23/2007
Last updated
03/14/2013
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