Pugh, Mary Annette

Pugh, Mary Annette is an individual health care provider with primary practice located at 2621 W Main St Suite 2A, Russellville AR 72801-2551. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pugh, Mary Annette can be contacted via phone (479) 567-5467.

Contact Information

Primary practice address
2621 W Main St Suite 2A Russellville AR 72801-2551
Phone: (479) 567-5467
Fax: (479) 219-5500
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E8561 Arkansas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26439 Oklahoma

Profile Details

NPI number 1831359082
LBN Legal business name Pugh, Mary Annette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2008
Last updated Jan 18th, 2024 - about 11 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831359082 NPPES
Oklahoma MEDICAID 200217590A
Oklahoma MEDICAID 200468380N
Oklahoma MEDICAID 100786900A

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