Healthcare Provider Details

I. General information

NPI: 1033041942
Provider Name (Legal Business Name): DANIEL JAMES PUGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E VAN BUREN ST
COLORADO SPRINGS CO
80907-6843
US

IV. Provider business mailing address

825 HUBBELL DR
COLORADO SPRINGS CO
80911-3526
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-8686
  • Fax:
Mailing address:
  • Phone: 719-322-8792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA.00822936
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: