Provider Demographics
NPI:1306835467
Name:HUGHES, PAMELA ALLISON (DO)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ALLISON
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:ALLISON
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1151 SMITH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59645-9674
Mailing Address - Country:US
Mailing Address - Phone:307-899-7991
Mailing Address - Fax:703-828-0257
Practice Address - Street 1:1151 SMITH RIVER RD
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59645-9674
Practice Address - Country:US
Practice Address - Phone:307-899-7991
Practice Address - Fax:703-828-0257
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14507A207Q00000X
MTMED-PHYS-LIC-104426207Q00000X
VA0102205909207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2402556Medicare ID - Type Unspecified
NCI30994Medicare UPIN