MEDICARE: CHARLES TANNER HUGHES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	036150634	IL

General Provider Information

NPI Number	:	1487944849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES TANNER HUGHES M.D.

Provider Business Mailing Address
First Line	:	101 MEMORIAL HOSPITAL DR
Second Line	:	SUITE 100
City	:	MOBILE
State	:	AL
Zip	:	36608-1786
Country	:	US
Telephone Number	:	251-343-9090
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 W WELLINGTON AVE STE 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-7187
Country	:	US
Telephone Number	:	773-281-1011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	09/03/2019

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