Provider Demographics
NPI:1093037376
Name:J PRESTON HUGHES A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:J PRESTON HUGHES A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-266-1409
Mailing Address - Street 1:1250 E 3900 S STE 320
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1350
Mailing Address - Country:US
Mailing Address - Phone:801-266-1409
Mailing Address - Fax:801-266-0685
Practice Address - Street 1:1250 E 3900 S STE 320
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1350
Practice Address - Country:US
Practice Address - Phone:801-266-1409
Practice Address - Fax:801-266-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-27
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151578-1205208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT04204OtherMEDICARE
UT46D0859166OtherCLEA
UT529545732006Medicaid
UT529545732006Medicaid