Healthcare Provider Details

I. General information

NPI: 1366584047
Provider Name (Legal Business Name): ROBERT PAUL HUGHES JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N 10TH ST STE H
FORT SMITH AR
72901-2703
US

IV. Provider business mailing address

115 N 10TH ST STE H
FORT SMITH AR
72901-2703
US

V. Phone/Fax

Practice location:
  • Phone: 479-790-7000
  • Fax:
Mailing address:
  • Phone: 479-790-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberR-1964
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: