Basic Information
Provider Information
NPI: 1255355194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PUGH
FirstName: RODNEY
MiddleName: VANCE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 50 SCHENCK PKWY
Address2: SUITE 300
City: ASHEVILLE
State: NC
PostalCode: 288033499
CountryCode: US
TelephoneNumber: 8286811527
FaxNumber:  
Practice Location
Address1: 76 PEACHTREE RD
Address2: SUITE 300
City: ASHEVILLE
State: NC
PostalCode: 288033131
CountryCode: US
TelephoneNumber: 8282541969
FaxNumber: 8282544611
Other Information
ProviderEnumerationDate: 07/26/2006
LastUpdateDate: 07/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X33598NCY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
896943905NC MEDICAID


Home