Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Mark Huckabee, DO

Individual provider Emergency Medicine Physician · NPI 1043705395

Ethan Mark Huckabee, DO is an Emergency Medicine in Carbondale, Illinois. Qualified in 2018, 8 years ago. Practices with Statera Health Care LLC, a 42-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Illinois and Michigan.

Years since qualifying
8
Licensed in
IL, MI
In the registry since
2018
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

405 W Jackson St
Carbondale, IL 62901-1462
Phone: (618) 549-0721
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 201 S 14th St, Herrin, IL 62948-3631 — (618) 942-2171
  • 1000 Health Center Dr, Mattoon, IL 61938-4644 — (217) 258-2551
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156
  • 939 Caroline St, Port Angeles, WA 98362-3997 — (360) 417-7000

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036162411 (IL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 5101026802 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 5101024216 (MI)

Record details

NPI number1043705395
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 28, 2018
Last updated in NPPESJune 6, 2024
Certification dateJune 6, 2024
Mailing address405 W Jackson St, Carbondale, IL 62901-1462

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Statera Health Care Llc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Carbondale