Organization
CHARLES E BAGLEY MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E BAGLEY (OWNER)
(912) 632-7203
Entity
Organization
Contact information
Practice address
210 E 16TH STREET, ALMA, GA 31510
(912) 632-7203
(912) 632-6491
Mailing address
PO BOX 220, ALMA, GA 31510
(912) 632-7203
(912) 632-6491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010858
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000098733A
—
GA
Enumeration date
08/17/2006
Last updated
03/05/2010
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