Keith B. Huckaby, M.D.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003757 Issued in GA

Legal business name

KEITH B. HUCKABY, M.D.

Practice address

519 W Main St
Thomaston, GA 30286-3504

Phone

(706) 647-1752

Fax

(706) 647-0339

NPI assigned

Mar 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Keith B. Huckaby, M. D.

Title

Physician

Phone

(706) 647-1752

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447389697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 W MAIN ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863504",
            "telephone_number": "706-647-1752",
            "fax_number": "706-647-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W MAIN ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863504",
            "telephone_number": "706-647-1752",
            "fax_number": "706-647-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH B. HUCKABY, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUCKABY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-647-1752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00304983A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Leanne Jobe, FNP-C
• Kionna Johnson, PHARMD
• Shauna Johnson, APRN, PMHNP
• Scott L Jones
• Virginia Sharron Jones, MD
• Kyjha Jashay Kendall
• Tina M Kent, N.P.
• Darryl Hugh Knight, M.D.
• Mary Knight
• Stephanie H Kong, M.D.

• Physician Assistant in Thomaston, GA
• Providers in Thomaston, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.