Provider Demographics
NPI:1740262542
Name:HUGHES, DOUGLAS S (DO)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9351 CORKSCREW RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6801
Mailing Address - Country:US
Mailing Address - Phone:239-561-5776
Mailing Address - Fax:239-333-1953
Practice Address - Street 1:9351 CORKSCREW RD STE 101
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6801
Practice Address - Country:US
Practice Address - Phone:239-561-5776
Practice Address - Fax:239-333-1953
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272881800Medicaid
FL04014OtherBC/BS OF FLORIDA
FL298227OtherAVMED
FL000013683GOtherHUMANA
FL298227OtherAVMED
I34291Medicare UPIN