Provider Demographics
NPI:1518638360
Name:HUGHES, THOMAS DEXTER (CERTIFIED HAIR LOSS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:DEXTER
Last Name:HUGHES
Suffix:
Gender:M
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16705 ROLLING GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6881
Mailing Address - Country:US
Mailing Address - Phone:912-226-9148
Mailing Address - Fax:
Practice Address - Street 1:101 GATLIN AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6950
Practice Address - Country:US
Practice Address - Phone:912-226-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management