Provider Demographics
NPI:1740223742
Name:HUGHES, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
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 1:3715 DAUPHIN ST
Mailing Address - Street 2:7A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1771
Mailing Address - Country:US
Mailing Address - Phone:251-410-3890
Mailing Address - Fax:251-410-3891
Practice Address - Street 1:3715 DAUPHIN ST
Practice Address - Street 2:7A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1771
Practice Address - Country:US
Practice Address - Phone:251-410-3890
Practice Address - Fax:251-410-3891
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0094725207V00000X
ALMD21529207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I160070OtherMEDICARE PTAN
AL51116396OtherBC AL
ALMD21529OtherAL MEDICAL LICENSE
FL274396500Medicaid
AL51116396OtherBC AL