Individual
MARY ANNETTE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2621 W MAIN ST, SUITE 2A, RUSSELLVILLE, AR 72801-2551
(479) 567-5467
(479) 219-5500
Mailing address
501 E B ST, RUSSELLVILLE, AR 72801-4129
(479) 567-5467
(479) 219-5500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26439
OK
207Q00000X
Family Medicine Physician
Primary
E8561
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100786900A
—
OK
05
—
200217590A
—
OK
05
—
200468380N
—
OK
Enumeration date
06/11/2008
Last updated
03/30/2026
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