Provider Demographics
NPI:1255356747
Name:HUGHES, J. LELAND JR (MD)
Entity type:Individual
Prefix:
First Name:J. LELAND
Middle Name:
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3918
Mailing Address - Country:US
Mailing Address - Phone:865-966-8987
Mailing Address - Fax:865-966-4873
Practice Address - Street 1:11551 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3918
Practice Address - Country:US
Practice Address - Phone:865-966-8987
Practice Address - Fax:865-966-4873
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD010361207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3037474OtherBCBS
TN4034635OtherAETNA
TN3005163Medicaid
TND74300Medicare UPIN
TN3005163Medicaid
TN110011009Medicare PIN