Provider Demographics
NPI:1063288033
Name:BUGG, CANDI JUNE
Entity type:Individual
Prefix:
First Name:CANDI
Middle Name:JUNE
Last Name:BUGG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 N MANNING ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-2950
Mailing Address - Country:US
Mailing Address - Phone:918-399-5321
Mailing Address - Fax:
Practice Address - Street 1:2116 N MANNING ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-2950
Practice Address - Country:US
Practice Address - Phone:918-399-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator