Provider Demographics
NPI:1790841054
Name:HUGHES, DENNIS EDWARD (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:EDWARD
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-1641
Mailing Address - Country:US
Mailing Address - Phone:417-235-3144
Mailing Address - Fax:417-235-3144
Practice Address - Street 1:801 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-1641
Practice Address - Country:US
Practice Address - Phone:417-235-3144
Practice Address - Fax:417-235-3144
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101872207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO244717104Medicaid
D05736Medicare UPIN
MO244717104Medicaid