Individual
JOHN TODD BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 CHANNING WAY STE 306, IDAHO FALLS, ID 83404-7546
(208) 535-4475
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
F6406
TX
207RI0200X
Infectious Disease Physician
M-13554
ID
Other
Enumeration date
07/18/2006
Last updated
11/21/2025
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