Organization
HUGHSTON CLINIC PC
Active
Organization
HUGHSTON CLINIC PC
Active
Other names
The Hughston Clinic, PC
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GRACE FROMKIN (DIRECTOR OF CREDENTIALING)
(706) 494-3071
Entity
Organization
Contact information
Practice address
100 MEDICAL DR STE 400, DUBLIN, GA 31021-2561
(706) 324-6661
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3071
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4725880022
MEDICARE DME
GA
Enumeration date
05/10/2018
Last updated
08/17/2023
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