Individual
SAMUEL W HUDDLESTON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
15029
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070707
BCBS
—
01
—
15029
LIC
—
05
—
3032417
—
TN
01
—
384053
ANTHEM
—
01
—
5331096
AETNA
—
Enumeration date
07/13/2006
Last updated
03/07/2023
Update your record
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