Healthcare Provider Details

I. General information

NPI: 1770752578
Provider Name (Legal Business Name): CHARLES E HUGHES III MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8051 S EMERSON AVE SUITE 450
INDIANAPOLIS IN
46237-8600
US

IV. Provider business mailing address

8051 S EMERSON AVE SUITE 450
INDIANAPOLIS IN
46237-8600
US

V. Phone/Fax

Practice location:
  • Phone: 317-859-3259
  • Fax: 317-859-3265
Mailing address:
  • Phone: 317-859-3259
  • Fax: 317-859-3265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES E HUGHES III
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 317-852-3259