Provider Demographics
NPI:1750102695
Name:PUGH, JOSIAH
Entity type:Individual
Prefix:
First Name:JOSIAH
Middle Name:
Last Name:PUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 REMINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2987
Mailing Address - Country:US
Mailing Address - Phone:970-484-4469
Mailing Address - Fax:
Practice Address - Street 1:400 REMINGTON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2983
Practice Address - Country:US
Practice Address - Phone:970-243-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program