Provider Demographics
NPI:1609815364
Name:HUGHES, LEON (PA,C)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PA,C
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 327
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:KS
Mailing Address - Zip Code:66956-0327
Mailing Address - Country:US
Mailing Address - Phone:785-378-3137
Mailing Address - Fax:785-378-3450
Practice Address - Street 1:102 S CENTER ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:KS
Practice Address - Zip Code:66956-2202
Practice Address - Country:US
Practice Address - Phone:785-378-3511
Practice Address - Fax:785-378-3919
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00146363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS042388OtherBLUE CROSS CLINIC
NEKS1500146Medicaid
KS042520OtherBLUE CROSS HOSPITAL
KS382790OtherFIRSTGUARD
KS042520OtherBLUE CROSS HOSPITAL
KSR94008Medicare UPIN