Healthcare Provider Details
I. General information
NPI: 1891321295
Provider Name (Legal Business Name): ZACHARY QUAY HUGHES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/17/2020
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3715 DAUPHIN ST STE 7A
MOBILE AL
36608-1775
US
IV. Provider business mailing address
PO BOX 11407 DEPT # 8094
BIRMINGHAM AL
35246-0100
US
V. Phone/Fax
- Phone: 251-410-4001
- Fax:
- Phone: 251-410-4002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 1592 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 1592 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: