Provider Demographics
NPI:1700813151
Name:HUGHES, WILLIAM S (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-2526
Mailing Address - Fax:417-347-2553
Practice Address - Street 1:702 E 34TH ST STE 202
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3921
Practice Address - Country:US
Practice Address - Phone:417-347-2526
Practice Address - Fax:417-347-2553
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8H07207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100183510AMedicaid
KS100231000DMedicaid
P00175241OtherRR MEDICARE
MO6168OtherANTHEM
MO242763605Medicaid
MO327633657Medicare PIN
MO6168OtherANTHEM