Healthcare Provider Details

I. General information

NPI: 1699512012
Provider Name (Legal Business Name): CHRISTOPHER HUGHES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ROSE ST
LEXINGTON KY
40536-1911
US

IV. Provider business mailing address

1550 TRENT BLVD APT 906
LEXINGTON KY
40515-1911
US

V. Phone/Fax

Practice location:
  • Phone: 502-229-8524
  • Fax:
Mailing address:
  • Phone: 502-229-8524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: