Provider Demographics
NPI:1104866672
Name:HUGHES, BRYAN C (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:C
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:187 N CHURCH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-5154
Mailing Address - Country:US
Mailing Address - Phone:800-932-2738
Mailing Address - Fax:888-761-8483
Practice Address - Street 1:1650 NE GRAND AVE STE 201
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6042
Practice Address - Country:US
Practice Address - Phone:888-701-4661
Practice Address - Fax:888-239-2595
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2025-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0445752207Q00000X
MO2006009612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2006009612OtherSTATE MEDICAL LICENSE
MOF88000012Medicare PIN
MOY36000023Medicare PIN