Basic Information
| Provider Information | |||||||||
| NPI: | 1306858873 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PUGH | ||||||||
| FirstName: | BASIL | ||||||||
| MiddleName: | LESTER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76 PEACHTREE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288033131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282541969 | ||||||||
| FaxNumber: | 8282544611 | ||||||||
| Practice Location | |||||||||
| Address1: | 76 PEACHTREE RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288033131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282541969 | ||||||||
| FaxNumber: | 8282544611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 12/04/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 9500427 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 8969450 | 05 | NC | MEDICAID |