Healthcare Provider Details

I. General information

NPI: 1063672657
Provider Name (Legal Business Name): LINDA MARIE HUGHSON OPA-C RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3370 E JOLLY
LANSING MI
48910
US

IV. Provider business mailing address

3370 E JOLLY
LANSING MI
48910
US

V. Phone/Fax

Practice location:
  • Phone: 517-487-3717
  • Fax: 517-364-0138
Mailing address:
  • Phone: 517-487-3717
  • Fax: 517-364-0138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1053
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number1053
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: