Individual
KENNETH ARTHUR BAGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 NE MARY ROSE PL STE 120, BEND, OR 97701-7132
(203) 688-2259
(203) 688-5599
Mailing address
2450 NE MARY ROSE PL STE 120, BEND, OR 97701-7132
(541) 312-3100
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD182448
OR
Other
Enumeration date
04/27/2012
Last updated
07/21/2022
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