Provider Demographics
NPI:1558940833
Name:BUGG, ALEX WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:WILLIAM
Last Name:BUGG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 DR. MLK JR. ST. N.
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704
Mailing Address - Country:US
Mailing Address - Phone:270-963-1723
Mailing Address - Fax:
Practice Address - Street 1:1519 DR. MLK JR. ST. N.
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704
Practice Address - Country:US
Practice Address - Phone:727-314-6472
Practice Address - Fax:727-619-2310
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS20272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine