Basic Information
| Provider Information | |||||||||
| NPI: | 1326029786 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUGHES | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S 12TH ST | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420719303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707599200 | ||||||||
| FaxNumber: | 2707599966 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S 12TH ST | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420719303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707599200 | ||||||||
| FaxNumber: | 2707599966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 10/15/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 22158 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64221583 | 05 | KY | MEDICAID | 000000050309 | 01 | KY | ANTHEM PROV NUMBER | OTHER | 010010427 | 01 | KY | RAILROAD MEDICARE PROV NU | OTHER |