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General NPI Number Information
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NPI Number | 1447406269
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Entity Type | Organization
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Legal Business Name | MICHAEL K. HUGHES, OD, LLC
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 1103 E BOXELDER RD SUITE F
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City | GILLETTE
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State | WY
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Zip | 82718-5582
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Country | US
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Telephone | 307-682-2747
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Fax | 307-686-9984
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Provider Business Mailing Address
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Address Line | 1103 E BOXELDER RD SUITE F
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City | GILLETTE
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State | WY
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Zip | 82718-5582
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Country | US
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Telephone | 307-682-2747
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Fax | 307-686-9984
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MICHAEL K. HUGHES
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Credential | O. D.
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Telephone | 307-682-2747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 129-T
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License Number State | WY
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