# BAGLEY ORTHOPEDIC TRAUMA & SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1952641367
- **Authorized official:** MICHAEL C BAGLEY DO (OWNER)
- **Authorized official phone:** (303) 888-5020

## Contact information

- **Practice address:** 15378 SPRUCE ST, BROOMFIELD, CO 80023-8779
- **Practice address phone:** (303) 888-5020
- **Practice address fax:** (303) 469-6793
- **Mailing address:** 5165 W 72ND AVE, WESTMINSTER, CO 80030-5137
- **Mailing address phone:** (303) 888-5020
- **Mailing address fax:** (303) 469-6793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 45154 | CO | Yes |

## Other

- **Enumeration date:** 02/21/2013
- **Last updated:** 02/21/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 89103769 | — | CO |