Organization
PRAXIDIO H. TAGALA,M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAXIDIO H TAGALA M.D. (PRESIDENT)
(814) 765-4369
Entity
Organization
Contact information
Practice address
615 THOMPSON ST, CLEARFIELD, PA 16830-1227
(814) 765-4369
(814) 768-7890
Mailing address
615 THOMPSON ST, CLEARFIELD, PA 16830-1227
(814) 765-4369
(814) 768-7890
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD038410-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0861458
—
PA
Enumeration date
10/22/2005
Last updated
11/07/2007
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