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NPI Code Detail

MEDICARE: KASA BLAINE PUGH M.D.

MEDICARE: KASA BLAINE PUGH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianE-15247AR
2207X00000XOrthopaedic Surgery Physician56387KY

General Provider Information

NPI Number : 1366805715
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASA BLAINE PUGH M.D.
Provider Business Mailing Address
First Line : 4301 W MARKHAM ST # 783
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-7101
Country : US
Telephone Number : 501-686-8000
Fax Number : 501-526-5148
Provider Business Practice Location Address
First Line : 801 COTTAGE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-5400
Country : US
Telephone Number : 501-686-6067
Fax Number : 501-296-1091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2016
Last Update Date : 05/26/2026

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