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Organization

SAM W. HUDDLESTON IV MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAM W HUDDLESTON MD (OWNER)
(423) 245-7080
Entity
Organization

Contact information

Practice address
2002 BROOKSIDE DR, SUITE# 201, KINGSPORT, TN 37660-4634
(423) 245-7080
(423) 245-7875
Mailing address
2002 BROOKSIDE DR, SUITE# 201, KINGSPORT, TN 37660-4634
(423) 245-7080
(423) 245-7875

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD15029
TN

Other

Enumeration date
10/08/2015
Last updated
10/08/2015
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