Bagley, Brent Alan
Bagley, Brent Alan is an individual health care provider with primary practice located at 550 University Blvd , Indianapolis IN 46202-5149. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Bagley, Brent Alan can be contacted via phone (317) 944-8660.Contact Information
Primary practice address
550 University Blvd
Indianapolis IN 46202-5149
Phone: (317) 944-8660
Fax: (317) 968-1012
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01083598A | Indiana |
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 01083598A | Indiana |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 11019260A | Indiana |
Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01083598A | Indiana |
Profile Details
NPI number | 1447788948 |
---|---|
LBN Legal business name | Bagley, Brent Alan |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 27th, 2017 |
Last updated | Aug 9th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1447788948 | NPPES |
Indiana | Other | 264910405 | MEDICARE PTAN |
Indiana | MEDICAID | 300066502 | MEDICARE PTAN |
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