Provider Demographics
NPI:1699971325
Name:HUGHES, KATHRINE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRINE
Middle Name:ELIZABETH
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 EAST BLVD
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-2483
Mailing Address - Country:US
Mailing Address - Phone:574-523-3161
Mailing Address - Fax:574-273-1137
Practice Address - Street 1:600 EAST BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2483
Practice Address - Country:US
Practice Address - Phone:574-523-3161
Practice Address - Fax:574-273-1137
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11013838A390200000X
IN01065541A207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000659026OtherANTHEM
IN200964940Medicaid
INP00836416OtherRAILROAD MEDICARE
INP00836416OtherRAILROAD MEDICARE