Individual
THOMAS BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3914 BELLA LN, FOLEY, AL 36535-9086
(706) 717-0803
(251) 955-6969
Mailing address
3914 BELLA LN, FOLEY, AL 36535-9086
(706) 717-0803
(251) 955-6969
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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