Basic Information
| Provider Information | |||||||||
| NPI: | 1114964855 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUG | ||||||||
| FirstName: | EUGEN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5901 W MEMORIAL RD | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731422015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057736700 | ||||||||
| FaxNumber: | 4057203910 | ||||||||
| Practice Location | |||||||||
| Address1: | 5901 W MEMORIAL RD | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731422015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057736700 | ||||||||
| FaxNumber: | 4057203910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 04/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 77737 | MA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 25MA08992100 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 0281522 | 05 | NJ | MEDICAID |