Healthcare Provider Details
I. General information
NPI: 1205160454
Provider Name (Legal Business Name): JOSEPH M. HUGHES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/21/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9596 E ROADRUNNER DR
SCOTTSDALE AZ
85262-1442
US
IV. Provider business mailing address
9596 E ROADRUNNER DR
SCOTTSDALE AZ
85262-1442
US
V. Phone/Fax
- Phone: 480-595-5141
- Fax: 480-595-5141
- Phone: 480-595-5141
- Fax: 480-595-5141
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | ARIZONA |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | 4936 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: