Provider Demographics
NPI:1043306525
Name:HUGHES, CRAIG DALE (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:DALE
Last Name:HUGHES
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:PO BOX 10700
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-5517
Mailing Address - Country:US
Mailing Address - Phone:970-254-2642
Mailing Address - Fax:
Practice Address - Street 1:1120 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6129
Practice Address - Country:US
Practice Address - Phone:970-241-6011
Practice Address - Fax:970-241-4650
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22601228Medicaid
376458YL92Medicare PIN
UTP00287325OtherRR MEDICARE
UTI33624Medicare UPIN
UT0102212OtherUHC
UT7156761OtherAETNA
UTP00287325OtherRR MEDICARE
UTI33624Medicare UPIN
UT107040115101OtherIHC
UT870526286OtherPHCS
UT241020OtherALTIUS
UTQMP000002261696OtherMOLINA
UT7156761OtherAETNA
UT870526286OtherFIRST HEALTH
UTP00287325OtherRR MEDICARE
UT870526286OtherCCN
UTI33624Medicare UPIN
UT107040115101OtherIHC
UT870526286OtherHUMANA
UT870526286OtherPHCS