Healthcare Provider Details

I. General information

NPI: 1114726395
Provider Name (Legal Business Name): JOSHUA RAJARATNAM HUGHES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 CENTRAL AVE BLDG 3349
EIELSON AFB AK
99702-3404
US

IV. Provider business mailing address

2630 CENTRAL AVE # 3349
EIELSON AFB AK
99702-2301
US

V. Phone/Fax

Practice location:
  • Phone: 907-377-6665
  • Fax:
Mailing address:
  • Phone: 907-377-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101290721
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: