Provider Demographics
NPI:1912977810
Name:HUGHEY, DON (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:HUGHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 370407
Mailing Address - Street 2:PATIENT ACCOUNTS OFFICE
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-3828
Mailing Address - Country:US
Mailing Address - Phone:404-212-5454
Mailing Address - Fax:404-243-2159
Practice Address - Street 1:3073 PANTHERSVILLE RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-3828
Practice Address - Country:US
Practice Address - Phone:404-212-5454
Practice Address - Fax:404-243-2159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R12854Medicare UPIN
68BBBXSMedicare ID - Type Unspecified