Provider Demographics
NPI:1740259779
Name:HUGHES, AMY K (PA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1440 N MUSTANG RD
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-7214
Mailing Address - Country:US
Mailing Address - Phone:405-280-7546
Mailing Address - Fax:405-578-3350
Practice Address - Street 1:1440 N MUSTANG RD
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064
Practice Address - Country:US
Practice Address - Phone:405-280-7546
Practice Address - Fax:405-578-3350
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK705363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
24R601344Medicare PIN