Individual
TIMOTHY W HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
204 8TH ST, GREENWOOD, MS 38930-4012
(662) 453-0504
Mailing address
303 E CLEVELAND AVE, GREENWOOD, MS 38930-3109
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
R860203
MS
Other
Enumeration date
12/16/2009
Last updated
12/16/2009
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