Provider Demographics
NPI:1891951521
Name:HUGO, ZACHARY (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:HUGO
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 1:8201 MISSION RD STE 261
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-5214
Mailing Address - Country:US
Mailing Address - Phone:913-649-0923
Mailing Address - Fax:913-649-0990
Practice Address - Street 1:8201 MISSION RD STE 261
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5214
Practice Address - Country:US
Practice Address - Phone:913-649-0923
Practice Address - Fax:913-649-0990
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN519452084P0800X
KS04-357432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MN260003039Medicare PIN