Provider Demographics
NPI:1700084233
Name:HUGHES, JOHN CLEVELAND (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CLEVELAND
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:227 MIDLAND AVE
Mailing Address - Street 2:18B
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-8364
Mailing Address - Country:US
Mailing Address - Phone:970-927-0308
Mailing Address - Fax:970-927-0394
Practice Address - Street 1:227 MIDLAND AVE
Practice Address - Street 2:18B
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-8364
Practice Address - Country:US
Practice Address - Phone:970-927-0308
Practice Address - Fax:970-927-0394
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47944208D00000X, 208D00000X
AZ005184208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice