Healthcare Provider Details

I. General information

NPI: 1740696814
Provider Name (Legal Business Name): KEVIN HUGHES PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 VETERANS WAY
PENSACOLA FL
32507-1000
US

IV. Provider business mailing address

790 VETERANS WAY
PENSACOLA FL
32507-1000
US

V. Phone/Fax

Practice location:
  • Phone: 850-505-6579
  • Fax:
Mailing address:
  • Phone: 850-505-6579
  • Fax: 850-452-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9109421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: