Healthcare Provider Details

I. General information

NPI: 1992779722
Provider Name (Legal Business Name): ALAN W HUGHES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MEDICAL PARK DR SUITE 300
BENTON AR
72015-3728
US

IV. Provider business mailing address

3 MEDICAL PARK DR STE 300
BENTON AR
72015-3726
US

V. Phone/Fax

Practice location:
  • Phone: 501-778-1113
  • Fax: 501-778-5391
Mailing address:
  • Phone: 501-778-1113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC7930
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: