Healthcare Provider Details
I. General information
NPI: 1164461190
Provider Name (Legal Business Name): HUGHSTON CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6262 VETERANS PKWY
COLUMBUS GA
31909-9517
US
IV. Provider business mailing address
6262 VETERANS PKWY
COLUMBUS GA
31909-9517
US
V. Phone/Fax
- Phone: 706-324-6661
- Fax: 706-494-3201
- Phone: 706-494-3193
- Fax: 706-494-3201
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARLA
MCMEANS
Title or Position: SYSTEM DIRECTOR OF CREDENTIALING
Credential:
Phone: 706-494-3171