Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 21305 | NV |
NPI | 1477908911 |
---|---|
Provider Name | Tyler Hughes |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95816-3384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 02/12/2021 |