Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME0049807 | FL |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME0049807 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME0049807 | FL |
NPI | 1215997366 |
---|---|
Provider Name | Willard Allen Hughes II |
First Address | Clearwater, FL 33756-4070 |
Second Address | Clearwater, FL 33756-4070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 21/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046727800 | (05) | FL |
D60984 | (02) | FL |