Individual
DR. RANDAL K HUGHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7747 W JEFFERSON BLVD, SUITE A, FORT WAYNE, IN 46804
(260) 459-8444
(260) 459-8443
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01039469
IN
207W00000X
Ophthalmology Physician
036093071
IL
207W00000X
Ophthalmology Physician
30120
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108303
ANTHEM
—
05
—
200094570
—
IN
01
—
289993
HEALTHLINK
—
01
—
5984162
AETNA
—
05
—
64301203
—
KY
Enumeration date
09/20/2005
Last updated
08/15/2018
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