Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 302 | UT |
NPI | 1013012715 |
---|---|
Provider Name | Dr. Ronald M Pugh |
First Address | Spanish Fork, UT 84660-2024 |
Second Address | Provo, UT 84604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 17/09/2008 |