Provider Demographics
NPI:1245287804
Name:WILLIAM B HUGHES MD PC
Entity type:Organization
Organization Name:WILLIAM B HUGHES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-235-0510
Mailing Address - Street 1:1421 E DRINKER STREET
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512
Mailing Address - Country:US
Mailing Address - Phone:267-235-0510
Mailing Address - Fax:215-707-1266
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:OUTPT BLDG 5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-952-0792
Practice Address - Fax:215-950-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7806302Medicaid
PA0017264110003Medicaid
NJ052848Medicare ID - Type Unspecified
NJ7806302Medicaid