Basic Information
| Provider Information | |||||||||
| NPI: | 1922050418 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOSTON | ||||||||
| FirstName: | HUGH | ||||||||
| MiddleName: | CHESTER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 PAUL BRYANT DR E | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354012094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450192 | ||||||||
| FaxNumber: | 2052472194 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 PAUL BRYANT DR E | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354012094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450192 | ||||||||
| FaxNumber: | 2052472194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 01/20/2010 | ||||||||
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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 | 207X00000X | 4213 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | 4213 | AL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
ID Information
| ID | Type | State | Issuer | Description | 51517550 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 51517549 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 51000588 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 000000588 | 05 | AL | MEDICAID |