Bagley, Terry L

Bagley, Terry L is an sole proprietor health care provider with primary practice located at 3700 N Windsong Dr , Prescott Valley AZ 86314-1253. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Bagley, Terry L can be contacted via phone (928) 772-6951.

Contact Information

Primary practice address
3700 N Windsong Dr Prescott Valley AZ 86314-1253
Phone: (928) 772-6951
Fax: (928) 772-6971
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 31433 Arizona

Profile Details

NPI number 1053365213
LBN Legal business name Bagley, Terry L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2006
Last updated Nov 6th, 2020 - about 5 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053365213 NPPES
Arizona Other DC9137 RAILROAD MEDICARE
Arizona Other AZ0765480 RAILROAD MEDICARE
Arizona MEDICAID 914300 RAILROAD MEDICARE

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