Organization
BAGLEY ORTHOPEDIC TRAUMA & SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BAGLEY DO (OWNER)
(303) 888-5020
Entity
Organization
Contact information
Practice address
15378 SPRUCE ST, BROOMFIELD, CO 80023-8779
(303) 888-5020
(303) 469-6793
Mailing address
5165 W 72ND AVE, WESTMINSTER, CO 80030-5137
(303) 888-5020
(303) 469-6793
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
45154
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89103769
—
CO
Enumeration date
02/21/2013
Last updated
02/21/2013
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