Individual
THOMAS BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1040907
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN062994
GA
Other
Enumeration date
09/04/2009
Last updated
10/01/2012
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