Provider Demographics
NPI:1225618994
Name:HUGHES, SAMUEL JORDAN (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:JORDAN
Last Name:HUGHES
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 COX RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6708
Mailing Address - Country:US
Mailing Address - Phone:804-270-0330
Mailing Address - Fax:804-270-1003
Practice Address - Street 1:4600 COX RD STE 120
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6708
Practice Address - Country:US
Practice Address - Phone:804-270-0330
Practice Address - Fax:804-270-1003
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101284736207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program