1376160176 NPI number — MR. MICHAEL WAYNE HUGHART II FNP

Table of content: MR. MICHAEL WAYNE HUGHART II FNP (NPI 1376160176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376160176 NPI number — MR. MICHAEL WAYNE HUGHART II FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHART
Provider First Name:
MICHAEL
Provider Middle Name:
WAYNE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
II
Provider Credential Text:
FNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376160176
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1448 10TH AVE STE 304
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-3579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-691-8722
Provider Business Mailing Address Fax Number:
304-399-6667

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1249 15TH ST STE 4000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-3663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-691-8500
Provider Business Practice Location Address Fax Number:
304-691-8510
Provider Enumeration Date:
06/29/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  105939 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com