Basic Information
| Provider Information | |||||||||
| NPI: | 1578552642 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUGGINS | ||||||||
| FirstName: | TYLER | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 STATE ROUTE 598 | ||||||||
| Address2: | |||||||||
| City: | GALION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448339367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194680111 | ||||||||
| FaxNumber: | 4194680113 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 STATE ROUTE 598 | ||||||||
| Address2: | |||||||||
| City: | GALION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448339367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194680111 | ||||||||
| FaxNumber: | 4194680113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2005 | ||||||||
| LastUpdateDate: | 12/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35-061763 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 341733066 | 01 | OH | TAX ID | OTHER | 0888204 | 05 | OH | MEDICAID |