Provider Demographics
NPI:1447206867
Name:HUGHES, WILLIAM (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 E DRINKER ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2655
Mailing Address - Country:US
Mailing Address - Phone:215-952-0792
Mailing Address - Fax:215-952-0794
Practice Address - Street 1:1100 WALNUT ST STE 500
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5563
Practice Address - Country:US
Practice Address - Phone:215-955-6750
Practice Address - Fax:215-923-8222
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054373L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017158200004Medicaid
PA010790Medicare ID - Type Unspecified
NJ052847Medicare ID - Type Unspecified
PA0017158200004Medicaid