Jacob Max Huddleston (NPI# 1023565330, PAC ID# 9234427295) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1023565330 |
| PAC ID by PECOS | 9234427295 |
| Professional Enrollment ID | I20161007000767 |
| Full Name | Jacob Max Huddleston |
| Organization Legal Name | ALLIANCE PHYSICIANS INC |
| Address |
550 W Main St New Lebanon OH 45345-9172 |
| Phone Number | 9376871911 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0840104360 |
| Number of Group Practice Members | 727 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360180 | CLEVELAND CLINIC |
| Address | Phone | Organization |
|---|---|---|
| 14401 Snow Rd, Suite 106, Brook Park, OH 44142-2583 | 2168982229 | THE CLEVELAND CLINIC FOUNDATION |
| 10685 Carnegie Ave, Suite X20, Cleveland, OH 44195-0001 | 2164443475 | THE CLEVELAND CLINIC FOUNDATION |
| 9500 Euclid Ave, Cleveland, OH 44195-0001 | THE CLEVELAND CLINIC FOUNDATION | |
| 303 Chestnut Commons Dr, Elyria, OH 44035-9607 | 4403669444 | THE CLEVELAND CLINIC FOUNDATION |
| 11851 Detroit Ave, Lakewood, OH 44107-3016 | 2166715006 | THE CLEVELAND CLINIC FOUNDATION |
| 5700 Cooper Foster Park Rd W, Lorain, OH 44053-4152 | 4402047400 | THE CLEVELAND CLINIC FOUNDATION |
| 5700 Cooper Foster Park W Rd, Lorain, OH 44053-4152 | 4402047400 | THE CLEVELAND CLINIC FOUNDATION |
| 550 W Main St, New Lebanon, OH 45345-9172 | 9376871911 | ALLIANCE PHYSICIANS INC |
| 19895 Detroit Rd, Rocky River, OH 44116-1815 | 2164442200 | THE CLEVELAND CLINIC FOUNDATION |
| Organization Legal Name | ALLIANCE PHYSICIANS INC |
| Physicians | 760 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katresha Janiece Williams-ellington | Nurse Practitioner | Alliance Physicians Inc | 3300 Philadelphia Dr, Dayton, OH 45405-1919 |
| Rebecca Anne Reynolds | Nurse Practitioner | Alliance Physicians Inc | 2141 N Fairfield Rd B, Beavercreek, OH 45431-2579 |
| Whitney Nicole Clark | Certified Nurse Midwife (cnm) | Alliance Physicians Inc | 50 N Progress Dr, Xenia, OH 45385-2666 |
| Akil P. Patel | Neurosurgery | Alliance Physicians Inc | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1263 |
| Charles William Oberer | Gastroenterology | Alliance Physicians Inc | 3359 Kemp Rd, Suite 100, Beavercreek, OH 45431-4204 |
| Rebecca Yeager | Family Medicine | Alliance Physicians Inc | 2145 N Fairfield Rd, Suite 100, Beavercreek, OH 45431-2580 |
| Jennifer Martin | Family Medicine | Alliance Physicians Inc | 825 N Main St, Suite 140, Springboro, OH 45066-1503 |
| Stefanie Kristine Lewis | Family Medicine | Alliance Physicians Inc | 1045 Channingway Dr, Fairborn, OH 45324-9252 |
| Angela A Adams-harrison | Family Medicine | Alliance Physicians Inc | 415 Byers Rd, Suite 300, Miamisburg, OH 45342-3684 |
| Michelle Bizzarro | Nurse Practitioner | Alliance Physicians Inc | 3371 Kemp Rd, Beavercreek, OH 45431-2514 |
| Street Address |
550 W MAIN ST |
| City | NEW LEBANON |
| State | OH |
| Zip | 45345-9172 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis A. Bingham Jr. | Internal Medicine | Alliance Physicians Inc | 550 W Main St, New Lebanon, OH 45345-9172 |
| Johnny W Myers | Nurse Practitioner | Alliance Physicians Inc | 550 W Main St, New Lebanon, OH 45345-9172 |
| Kathryn A Griffiths | Clinical Social Worker | 550 W Main St, Boonton, NJ 07005-1168 | |
| Maureen Mcgreal | Clinical Social Worker | 550 W Main St, Boonton, NJ 07005-1168 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jin Chung | Family Practice | Samaritan Family Care Inc | 220 E Main St, New Lebanon, OH 45345-1254 |
| Robert Andre De Roziere | Nurse Practitioner | Kimberly S. Neace, Msn, Cnp, LLC | 101 Mills Pl, New Lebanon, OH 45345-1430 |
| Kimberly S Neace | Nurse Practitioner | Kimberly S. Neace, Msn, Cnp, LLC | 101 Mills Pl, New Lebanon, OH 45345-1430 |
| City | NEW LEBANON |
| Zip Code | 45345 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | NEW LEBANON + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.