Provider Demographics
NPI:1518923531
Name:TUGGLE, ANNE S (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:S
Last Name:TUGGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 JENKINS ST
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2412
Mailing Address - Country:US
Mailing Address - Phone:864-288-1941
Mailing Address - Fax:864-288-1946
Practice Address - Street 1:11 JENKINS ST
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2412
Practice Address - Country:US
Practice Address - Phone:864-288-1941
Practice Address - Fax:864-288-1946
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC240821Medicaid
SC8272OtherMEDICARE GROUP NUMBER
SCGP4225OtherMEDICAID GROUP NUMBER
SC240821Medicaid
SC8272OtherMEDICARE GROUP NUMBER