Healthcare Provider Details

I. General information

NPI: 1023446028
Provider Name (Legal Business Name): HUGHES ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 INDIAN WELLS RD SUITE B
ALAMOGORDO NM
88310-4611
US

IV. Provider business mailing address

PO BOX 4860
MURRELLS INLET SC
29576-2698
US

V. Phone/Fax

Practice location:
  • Phone: 575-437-0890
  • Fax:
Mailing address:
  • Phone: 916-479-3268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberCRNA-01086
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License NumberCRNA-01086
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberCRNA-01086
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. CLIFFORD EUGENE HUGHES
Title or Position: CRNA
Credential:
Phone: 916-479-3268