Individual
DR. JAMES E. HUIZENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 298-3399
Mailing address
8280 YANKEE ST, CENTERVILLE, OH 45458-1806
(937) 436-4658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35080845
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2407327
—
OH
01
—
4122693
MEDICARE PTAN
OH
01
—
4122694
MEDICARE PTAN
OH
Enumeration date
10/31/2005
Last updated
03/16/2018
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