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Individual

ARNOLD P AGBUNAG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11394
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3626426
TN
01
4011551
BCBS TENNESSEE
TN
01
430066652
MEDICARE RAILROAD
TN
05
7007436
KY
Enumeration date
12/29/2005
Last updated
07/13/2010
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