=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669454443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW G HUGHES MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2005
-----------------------------------------------------
Last Update Date | 12/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1410 S 7TH AVE
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751-4557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-526-2589
-----------------------------------------------------
Fax | 970-526-0244
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 20970
-----------------------------------------------------
City | CHEYENNE
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82003-7020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-773-8237
-----------------------------------------------------
Fax | 307-773-8013
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | DR.00286682
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------