1912922261 NPI number — DR. ROBERT B HUGHES PHD

Table of content: DR. ROBERT B HUGHES PHD (NPI 1912922261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912922261 NPI number — DR. ROBERT B HUGHES PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
ROBERT
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
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:
1912922261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 REDBUSH CT
Provider Second Line Business Mailing Address:
STE 2
Provider Business Mailing Address City Name:
JOHNSON CITY
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37601-4340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-952-0992
Provider Business Mailing Address Fax Number:
423-283-7135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 REDBUSH CT
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37601-4340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-952-0992
Provider Business Practice Location Address Fax Number:
423-283-7135
Provider Enumeration Date:
07/13/2006

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: 103G00000X , with the licence number:  1897 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00712928 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3980369 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2802942 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3109492 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7599005 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 2017992 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 383472 . This is a "THC TN HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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