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General NPI Number Information
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NPI Number | 1376767418
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Entity Type | Organization
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Legal Business Name | BLUEGRASS GASTROENTEROLOGY ASSOCIATES P.S.C.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 96 C MICHAEL DAVENPORT BLVD
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City | FRANKFORT
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State | KY
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Zip | 40601-4333
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Country | US
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Telephone | 502-875-7000
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Fax | 502-875-0100
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Provider Business Mailing Address
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Address Line | 96 C MICHAEL DAVENPORT BLVD
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City | FRANKFORT
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State | KY
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Zip | 40601-4333
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Country | US
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Telephone | 502-875-7000
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Fax | 502-875-0100
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK HUGHES
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Credential | M.D.
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Telephone | 502-875-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 29217
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License Number State | KY
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