Provider Demographics
NPI:1205837705
Name:HUGHART, JIOVANNE NEAL (AUD)
Entity Type:Individual
Prefix:DR
First Name:JIOVANNE
Middle Name:NEAL
Last Name:HUGHART
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 OLDE TOWNE PKWY
Mailing Address - Street 2:STE 360
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4357
Mailing Address - Country:US
Mailing Address - Phone:770-971-1533
Mailing Address - Fax:770-971-4846
Practice Address - Street 1:4800 OLDE TOWNE PKWY
Practice Address - Street 2:STE 360
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4357
Practice Address - Country:US
Practice Address - Phone:770-971-1533
Practice Address - Fax:770-971-4846
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA937231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000664782HMedicaid
GA000664782AMedicaid
GAR55658Medicare UPIN
GA202I643916Medicare PIN