Provider Demographics
NPI:1013909191
Name:HUGHES, CHARLES DARREN
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DARREN
Last Name:HUGHES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 N BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2201
Mailing Address - Country:US
Mailing Address - Phone:816-279-3319
Mailing Address - Fax:816-279-4332
Practice Address - Street 1:1918 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2201
Practice Address - Country:US
Practice Address - Phone:816-279-3319
Practice Address - Fax:816-279-4332
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE005172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12859037OtherBCBS
MOI335976Medicare ID - Type Unspecified
MO12859037OtherBCBS