Physician Compare National (NPI:1831359082)

HEALTHCARE PROVIDER: MARY ANNETTE PUGH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831359082
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739360504
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140613000416
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PUGH
	Individual professional last name
Provider First Name	MARY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	OBSTETRICS/GYNECOLOGY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE, OBSTETRICS/GYNECOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	200 N 3RD ST
	Group Practice or individual's line 1 address
City	DARDANELLE
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	728343802
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	041313
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OZARK HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040041
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST MARYS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	371337
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	EASTERN OKLAHOMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	041302
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	RIVER VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	040002
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	JOHNSON REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1831359082)

HEALTHCARE PROVIDER: MARY ANNETTE PUGH MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information