Provider Demographics
NPI:1154381317
Name:HUGHES, THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
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 1:64 DAVISON CT
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5370
Mailing Address - Country:US
Mailing Address - Phone:716-433-8640
Mailing Address - Fax:716-433-4897
Practice Address - Street 1:64 DAVISON CT
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5370
Practice Address - Country:US
Practice Address - Phone:716-433-8640
Practice Address - Fax:716-433-4897
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01054324Medicaid
NY01054324Medicaid
NYE95284Medicare UPIN