MEDICARE: LAUREN VICTORIA PORTER HUGHES MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	04-42149	KS

General Provider Information

NPI Number	:	1811438013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN VICTORIA PORTER HUGHES MD

Provider Business Mailing Address
First Line	:	2870 W 47TH AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-3243
Country	:	US
Telephone Number	:	913-735-3551
Fax Number	:

Provider Business Practice Location Address
First Line	:	2870 W 47TH AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-3243
Country	:	US
Telephone Number	:	913-735-3551
Fax Number	:

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

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	05/27/2022

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