Healthcare Provider Details
I. General information
NPI: 1700979705
Provider Name (Legal Business Name): SCOTT WESLEY HUGHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 05/19/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2501 CAPEHART RD
OFFUTT AFB NE
68113-1043
US
IV. Provider business mailing address
815 VALENTINE LN
PAPILLION NE
68046-6237
US
V. Phone/Fax
- Phone: 402-232-8647
- Fax:
- Phone: 402-557-6144
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 5490 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: