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NPI Code Detail

MEDICARE: MRS. AMANDA FAYE HUGHES LDO

MEDICARE: MRS. AMANDA FAYE HUGHES LDO
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
1156FX1800XOptician11374OH

General Provider Information

NPI Number : 1346947793
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA FAYE HUGHES LDO
Provider Business Mailing Address
First Line : 2485 POSSUM RUN RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-9447
Country : US
Telephone Number : 419-756-7295
Fax Number : 419-756-7574
Provider Business Practice Location Address
First Line : 2485 POSSUM RUN RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-9447
Country : US
Telephone Number : 419-756-7295
Fax Number : 419-756-7574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2023
Last Update Date : 02/15/2023

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