Basic Information
Provider Information
NPI: 1972063931
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGHETT
FirstName: CHAD
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 DICK LONAS RD UNIT 101
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091383
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber: 8655841363
Practice Location
Address1: 7744 CONNER RD
Address2:  
City: POWELL
State: TN
PostalCode: 378493509
CountryCode: US
TelephoneNumber: 8655469751
FaxNumber: 8653059144
Other Information
ProviderEnumerationDate: 03/24/2019
LastUpdateDate: 07/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4398TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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