Provider Demographics
NPI:1669454443
Name:HUGHES, ANDREW G (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:G
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:PO BOX 20970
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7020
Mailing Address - Country:US
Mailing Address - Phone:307-773-8237
Mailing Address - Fax:307-773-8013
Practice Address - Street 1:1410 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4557
Practice Address - Country:US
Practice Address - Phone:970-526-2589
Practice Address - Fax:970-526-0244
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00286682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1286822Medicaid
CO330396YL0XMedicare PIN
CO330396YL0XMedicare PIN
COE41159Medicare UPIN
CO330396YL0XMedicare PIN
CO551498Medicare ID - Type Unspecified