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Individual

DR. METT BAGLEY AUSLEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 JEFFERSON ST, WHITEVILLE, NC 28472-3634
(910) 642-1715
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
38004
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12237
BCBS OF NC
NC
01
220023875
RAILROAD MEDICARE
05
8912237
NC
Enumeration date
02/21/2006
Last updated
05/14/2020
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