Provider Demographics
NPI:1922050418
Name:BOSTON, HUGH CHESTER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:CHESTER
Last Name:BOSTON
Suffix:JR
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 1:305 PAUL BRYANT DR E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2094
Mailing Address - Country:US
Mailing Address - Phone:205-345-0192
Mailing Address - Fax:205-247-2194
Practice Address - Street 1:305 PAUL BRYANT DR E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2094
Practice Address - Country:US
Practice Address - Phone:205-345-0192
Practice Address - Fax:205-247-2194
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4213207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51517550OtherBLUE CROSS BLUE SHIELD
AL51517549OtherBLUE CROSS BLUE SHIELD
AL51000588OtherBLUE CROSS BLUE SHIELD
AL000000588Medicaid
AL51000588OtherBLUE CROSS BLUE SHIELD
ALC75317Medicare UPIN