# CHARLES E BAGLEY MDPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093829343
- **Authorized official:** CHARLES E BAGLEY (OWNER)
- **Authorized official phone:** (912) 632-7203

## Contact information

- **Practice address:** 210 E 16TH STREET, ALMA, GA 31510
- **Practice address phone:** (912) 632-7203
- **Practice address fax:** (912) 632-6491
- **Mailing address:** PO BOX 220, ALMA, GA 31510
- **Mailing address phone:** (912) 632-7203
- **Mailing address fax:** (912) 632-6491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 010858 | GA | Yes |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 03/05/2010