Provider Demographics
NPI:1356467617
Name:HUGHES, MICHAEL DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 FAIRPLAY ST
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30663-2377
Mailing Address - Country:US
Mailing Address - Phone:706-557-0211
Mailing Address - Fax:
Practice Address - Street 1:113 FAIRPLAY ST
Practice Address - Street 2:
Practice Address - City:RUTLEDGE
Practice Address - State:GA
Practice Address - Zip Code:30663-2377
Practice Address - Country:US
Practice Address - Phone:706-557-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU73815Medicare UPIN
GAGRP3335Medicare ID - Type Unspecified