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Organization
LIFESTAGES OB-GYN PLLC
Active
Organization
LIFESTAGES OB-GYN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTAN HUGHES M.D. (OWNER)
(208) 442-8038
Entity
Organization
Contact information
Practice address
3908 E FLAMINGO AVE, NAMPA, ID 83687-3102
(208) 442-8035
(208) 442-8038
Mailing address
3908 E FLAMINGO AVE, NAMPA, ID 83687-3102
(208) 442-8035
(208) 442-8038
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
M8055
ID
207V00000X
Obstetrics & Gynecology Physician
Primary
M8105
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806339500
—
ID
05
—
806575300
—
ID
05
—
807138400
—
ID
Enumeration date
03/20/2007
Last updated
12/26/2024
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