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Contact Information

MATTHEW D HUCKABY, MD
969 LAKELAND DRIVE
EMERGENCY DEPARTMENT
JACKSON, MS39216
 Phone: 601-200-6175
 Fax: 601-200-2020
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MATTHEW D HUCKABY · (Male)

NPI Number 1194144824
Status Active
Credentials MD
Entity Individual
Enumeration date 04/09/2014
Last updated 06/08/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # MD.208248
  • MS License # 24709
  • MS Medicaid 08627073
Hospital affiliation(s)
  • BAPTIST MEMORIAL HOSPITAL BOONEVILLE - (Acute Care)
    100 HOSPITAL DRIVE
    BOONEVILLE, MS 38829
  • MAGNOLIA REGIONAL HEALTH CENTER - (Acute Care)
    611 ALCORN DRIVE
    CORINTH, MS 38834
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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