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Individual

DR. KENNETH C. PUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
91-2135 FORT WEAVER RD FL 3, EWA BEACH, HI 96706-1940
(808) 691-3352
(808) 691-3355
Mailing address
91-2135 FORT WEAVER RD FL 3, EWA BEACH, HI 96706-1940
(808) 691-3352
(808) 691-3355

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
80330
TX
231H00000X
Audiologist
Primary
AUD-88
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000245423
HMSA BILLING NUMBER
HI
05
55114401
HI
Enumeration date
03/02/2007
Last updated
06/09/2021
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