Basic Information
| Provider Information | |||||||||
| NPI: | 1417449562 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUBER | ||||||||
| FirstName: | AUSTIN | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | GC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E 23RD ST STE 360 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223950 | ||||||||
| FaxNumber: | 6053223960 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E 23RD ST STE 360 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223950 | ||||||||
| FaxNumber: | 6053223960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2018 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.