Individual
DR. SAM BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 VIDUTA PL SE, HUNTSVILLE, AL 35801-1031
(256) 714-2684
(256) 489-7119
Mailing address
401 VIDUTA PL SE, HUNTSVILLE, AL 35801-1031
(256) 714-2684
(256) 489-7119
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4341A
WY
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
4131A
WY
Other
Enumeration date
09/27/2008
Last updated
09/27/2008
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