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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053365213 | NPPES |
| Arizona | Other | DC9137 | RAILROAD MEDICARE |
| Arizona | Other | AZ0765480 | RAILROAD MEDICARE |
| Arizona | MEDICAID | 914300 | RAILROAD MEDICARE |
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