Individual
DR. IVAN DARRELL PUGH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2094 E STATE ST, SUITE A, SALEM, OH 44460
(330) 337-2868
(330) 337-2875
Mailing address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 337-2868
(330) 337-2875
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34-00-7483-P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2890484
—
OH
Enumeration date
10/26/2005
Last updated
09/19/2024
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