Provider Demographics
NPI:1205808680
Name:HUFF, KALAICHELVI R (MD)
Entity type:Individual
Prefix:
First Name:KALAICHELVI
Middle Name:R
Last Name:HUFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KALAI
Other - Middle Name:R
Other - Last Name:HUFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-556-6479
Mailing Address - Fax:417-621-0404
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-556-6479
Practice Address - Fax:417-621-0404
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-3494207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143923001Medicaid
AR5N328Medicare ID - Type Unspecified
AR143923001Medicaid