Individual
BRENTEN CLARK PUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7478 CAMPUS VIEW DR, SUITE 100, WEST JORDAN, UT 84084-1966
(801) 280-7774
(801) 748-2790
Mailing address
PO BOX 572528, SALT LAKE CITY, UT 84157-2528
(801) 747-7279
(801) 747-7237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5054030-1205
UT
Other
Enumeration date
05/28/2006
Last updated
08/13/2007
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