Individual
DR. BRADLEY RICHARD ZAGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH SREET DEPARTMENT OF SURGERY, AUGUSTA, GA 30912-2300
(706) 721-4686
(706) 721-6828
Mailing address
1499 WALTON WAY, SUITE 1400, ATTN: DRAIFORD, AUGUSTA, GA 30901
(706) 828-8401
(706) 722-7235
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101236790
VA
208600000X
Surgery Physician
Primary
079033
GA
208600000X
Surgery Physician
2014-00014
NC
208600000X
Surgery Physician
35095068
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079033
GA LICENSE
GA
Enumeration date
07/06/2006
Last updated
03/01/2024
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