Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 58735 | TN |
Y | 111NI0900X | Internist | 58735 | TN |
NPI | 1003294992 |
---|---|
Provider Name | Dr. Spencer Pugh |
First Address | Knoxville, TN 37920-1511 |
Second Address | Knoxville, TN 37920-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 26/12/2019 |