Healthcare Provider Details

I. General information

NPI: 1689869265
Provider Name (Legal Business Name): JOHN EDWARD HUGHES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 ATLEE RD
MECHANICSVILLE VA
23116-1844
US

IV. Provider business mailing address

8260 ATLEE RD
MECHANICSVILLE VA
23116-1844
US

V. Phone/Fax

Practice location:
  • Phone: 804-764-6300
  • Fax:
Mailing address:
  • Phone: 804-764-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE6003
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102202336
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: