Healthcare Provider Details

I. General information

NPI: 1982696639
Provider Name (Legal Business Name): CHARLES GENE HUGHES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 MISSION HILL WAY
COLORADO SPRINGS CO
80921-2671
US

IV. Provider business mailing address

685 MISSION HILL WAY
COLORADO SPRINGS CO
80921-2671
US

V. Phone/Fax

Practice location:
  • Phone: 719-488-8724
  • Fax: 719-531-9545
Mailing address:
  • Phone: 719-488-8724
  • Fax: 719-531-9545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number22263
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number22263
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number22263
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: