MEDICARE: MRS. MESHIA K HUGHES PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	085001578	IL
2	363A00000X	Physician Assistant	085001578	IL

General Provider Information

NPI Number	:	1245288802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MESHIA K HUGHES PA-C

Provider Business Mailing Address
First Line	:	510 LINCOLN DR
Second Line	:
City	:	HERRIN
State	:	IL
Zip	:	62948-6334
Country	:	US
Telephone Number	:	618-997-6800
Fax Number	:	618-997-1187

Provider Business Practice Location Address
First Line	:	510 LINCOLN DR
Second Line	:
City	:	HERRIN
State	:	IL
Zip	:	62948-6334
Country	:	US
Telephone Number	:	618-997-6800
Fax Number	:	618-997-1187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/12/2023

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