Healthcare Provider Details

I. General information

NPI: 1720034077
Provider Name (Legal Business Name): PAUL JAMES NUGENT M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8405 N FRESNO ST SUITE 110
FRESNO CA
93720-1537
US

IV. Provider business mailing address

8405 N FRESNO ST SUITE 110
FRESNO CA
93720-1537
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-7645
  • Fax: 559-432-1915
Mailing address:
  • Phone: 559-449-7645
  • Fax: 559-432-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG53065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG53065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: