Provider Demographics
NPI:1447299698
Name:HUGGETT, JEFFREY M (MD)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:M
Last Name:HUGGETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:3024 BUSINESS PARK CIR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3132
Practice Address - Country:US
Practice Address - Phone:615-851-6033
Practice Address - Fax:615-851-2018
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD373472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509270OtherMEDICAID - MTI
TN3883862Medicaid
TN4062691OtherBCBS
TN4062694OtherBCBS
TN6440642OtherCIGNA
TN4291387OtherBCBS - MTI
TN4089871OtherBCBS
TNP00942156OtherRR MEDICARE - MTI
TN1509270Medicaid
KY64064280OtherKY MEDICAID
TNP00011592OtherRAILROAD MEDICAID
TN6440642OtherCIGNA
TN3883863Medicare PIN
TNP00942156OtherRR MEDICARE - MTI
TN103I306933Medicare PIN
TN4062691OtherBCBS
TN1509270Medicaid