Provider Demographics
NPI:1043324957
Name:HUGHES, JOHN ROBERT SR (NPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:HUGHES
Suffix:SR
Gender:M
Credentials:NPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:225 GOLDEN LEAF LN
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-9764
Mailing Address - Country:US
Mailing Address - Phone:318-466-2000
Mailing Address - Fax:318-466-2000
Practice Address - Street 1:2495 SHREVEPORT HIGHWAY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:318-473-2501
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAPO4224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily