Provider Demographics
NPI:1134344179
Name:HUGO, JOHN ADAM II (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADAM
Last Name:HUGO
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11208 GWATHMEY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7621
Mailing Address - Country:US
Mailing Address - Phone:804-798-6364
Mailing Address - Fax:
Practice Address - Street 1:11208 GWATHMEY CHURCH RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7621
Practice Address - Country:US
Practice Address - Phone:804-798-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000704103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA016352C90Medicare PIN