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Individual

KELLY GARVER BAGNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M. D.

Contact information

Practice address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
(406) 883-8926
Mailing address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
(406) 883-8926

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
8448
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000024905
MT
Enumeration date
07/01/2006
Last updated
04/14/2021
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