Provider Demographics
NPI:1194765776
Name:O'KELLEY-HUGHES, PATRICIA R (OD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:O'KELLEY-HUGHES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BIENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:36564
Mailing Address - Country:US
Mailing Address - Phone:228-875-3318
Mailing Address - Fax:228-875-3398
Practice Address - Street 1:2510 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:36564
Practice Address - Country:US
Practice Address - Phone:228-875-3318
Practice Address - Fax:228-875-3398
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD000001839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS751OtherMISSISSIPPI
MS05402731Medicaid
TN4109983OtherBCBS
U38219Medicare UPIN