Individual
HERBERT JAMES HUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
404 N PLEASANT AVE, CENTRALIA, IL 62801-3006
(618) 339-9872
(618) 533-6816
Mailing address
404 N PLEASANT AVE, CENTRALIA, IL 62801-3006
(618) 339-9872
(618) 533-6816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001637
IL
Other
Enumeration date
08/09/2005
Last updated
05/15/2013
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