Individual provider · NPI-1

Dr. Sam Bagley, M.D.

Anesthesiology · Huntsville, AL

NPI number1083864904
StatusActive
Last updated in NPPESSep 27, 2008

Details

NPI
1083864904
Entity type
Individual (NPI-1)
Name
Dr. Sam Bagley
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 27, 2008
Last updated
Sep 27, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207L00000X Anesthesiology4341AWYYes
207LC0200X Anesthesiology, Critical Care Medicine4131AWY

Practice location

401 Viduta Pl Se
Huntsville, AL 35801-1031

Phone 256-714-2684 · Fax 256-489-7119

Mailing address

401 Viduta Pl Se
Huntsville, AL 35801-1031

Phone 256-714-2684 · Fax 256-489-7119

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