Provider Demographics
NPI:1518373216
Name:HUGH SCARBROUGH OD
Entity Type:Organization
Organization Name:HUGH SCARBROUGH OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:731-986-4162
Mailing Address - Street 1:159 COURT SQ
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-3709
Mailing Address - Country:US
Mailing Address - Phone:731-986-4162
Mailing Address - Fax:731-986-4151
Practice Address - Street 1:159 COURT SQ
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-3709
Practice Address - Country:US
Practice Address - Phone:731-986-4162
Practice Address - Fax:731-986-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU01204Medicare UPIN
103I417924Medicare PIN