Provider Demographics
NPI:1043241201
Name:PUGNO, PERRY ALAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:ALAN
Last Name:PUGNO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11400 TOMAHAWK CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-2672
Mailing Address - Country:US
Mailing Address - Phone:800-274-2237
Mailing Address - Fax:913-906-6289
Practice Address - Street 1:11400 TOMAHAWK CREEK PKWY
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-2672
Practice Address - Country:US
Practice Address - Phone:800-274-2237
Practice Address - Fax:913-906-6289
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30137207Q00000X
KS28471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine