MEDICARE: DR. CODY ALLEN HUGHES DMD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	D-0006755-C1	AL

General Provider Information

NPI Number	:	1982237582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CODY ALLEN HUGHES DMD

Provider Business Mailing Address
First Line	:	27205 US HIGHWAY 29
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36421-9467
Country	:	US
Telephone Number	:	334-804-1978
Fax Number	:

Provider Business Practice Location Address
First Line	:	8324 CROSSLAND LOOP
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-8482
Country	:	US
Telephone Number	:	334-279-1166
Fax Number	:

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

Provider Enumeration Date	:	02/21/2020
Last Update Date	:	06/22/2021

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