Provider Demographics
NPI:1275966756
Name:HUGHES, SAMUEL PARKS
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:PARKS
Last Name:HUGHES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3049
Mailing Address - Country:US
Mailing Address - Phone:404-778-1440
Mailing Address - Fax:404-778-1401
Practice Address - Street 1:1428 DUNWOODY VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4123
Practice Address - Country:US
Practice Address - Phone:770-394-3258
Practice Address - Fax:770-394-3055
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA85532208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics