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Individual

AJIT S NAGRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
(417) 621-0571
Mailing address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
(417) 621-0571

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036108392
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08220357
BCBS GRP#
IL
01
900068033
TAX-ID#
IL
Enumeration date
07/06/2005
Last updated
04/14/2025
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