Individual
JACOB LAMAR PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2432 CONCORD AVE, SANTA CLARA, UT 84765-5621
(435) 429-0944
Mailing address
2432 CONCORD AVE, SANTA CLARA, UT 84765-5621
(435) 429-0944
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10959210-1206
UT
Other
Enumeration date
08/29/2018
Last updated
11/16/2020
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