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General NPI Number Information
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NPI Number | 1629497060
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Entity Type | Organization
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Legal Business Name | EVERARD H HUGHES M.D PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 3798 JANES RD SUITE 10
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City | ARCATA
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State | CA
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Zip | 95521-4753
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Country | US
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Telephone | 707-633-6517
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Fax | 707-633-6518
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Provider Business Mailing Address
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Address Line | 3798 JANES RD SUITE 10
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City | ARCATA
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State | CA
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Zip | 95521-4753
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Country | US
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Telephone | 707-633-6517
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Fax | 707-633-6518
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Authorized Official
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Title or Position | CEO
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Name | DR. EVERARD HUDSON HUGHES
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Credential | M.D.
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Telephone | 620-640-1237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3568483
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 3568483
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 3568483
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License Number State | CA
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