Provider Demographics
NPI:1861116048
Name:PUGH, MARION CHRISTOPHER (MED, EDD)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:CHRISTOPHER
Last Name:PUGH
Suffix:
Gender:M
Credentials:MED, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S COLLEGE ST # 623
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-4856
Mailing Address - Country:US
Mailing Address - Phone:470-222-5462
Mailing Address - Fax:
Practice Address - Street 1:4210 COLUMBIA RD STE 11B
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0443
Practice Address - Country:US
Practice Address - Phone:706-364-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health