Organization
KEITH B. HUCKABY, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH B. HUCKABY M. D. (PHYSICIAN)
(706) 647-1752
Entity
Organization
Contact information
Practice address
519 W MAIN ST, THOMASTON, GA 30286-3504
(706) 647-1752
(706) 647-0339
Mailing address
519 W MAIN ST, THOMASTON, GA 30286-3504
(706) 647-1752
(706) 647-0339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003757
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00304983A
—
GA
Enumeration date
03/05/2007
Last updated
08/22/2020
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