Organization
EMERGENCY MEDICINE PHYSICIANS OF ESTILL COUNTY,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC BAGNOLI (EXECUTIVE CHAIRMAN)
(330) 493-4443
Entity
Organization
Contact information
Practice address
60 MERCY CT, IRVINE, KY 40336
(330) 493-4443
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
(330) 493-8677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/21/2015
Last updated
06/25/2018
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