Provider Demographics
NPI:1518975465
Name:HUGHES, DOUGLAS BEASON JR (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BEASON
Last Name:HUGHES
Suffix:JR
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:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29731
Mailing Address - Country:US
Mailing Address - Phone:803-327-3700
Mailing Address - Fax:803-327-4273
Practice Address - Street 1:332 E WHITE ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730
Practice Address - Country:US
Practice Address - Phone:803-327-3700
Practice Address - Fax:803-327-4273
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T24043Medicare UPIN
SCT240430281Medicare ID - Type Unspecified