Provider Demographics
NPI:1780061754
Name:PUGH, JAMES LUTHER JR (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LUTHER
Last Name:PUGH
Suffix:JR
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:2 READS WAY
Mailing Address - Street 2:STE. 201
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-1630
Mailing Address - Country:US
Mailing Address - Phone:302-709-4709
Mailing Address - Fax:302-709-4551
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-1320
Practice Address - Country:US
Practice Address - Phone:302-733-1000
Practice Address - Fax:302-733-2685
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2016-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DE103052367500000X
DEL1-0034009163W00000X
NJ26NR15684500163W00000X
PARN535061163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE441571Y0JMedicare UPIN