Bagby, Jack M
Bagby, Jack M is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bagby, Jack M can be contacted via phone (417) 820-2829.Contact Information
Primary practice address
1235 E Cherokee St
Springfield MO 65804-2203
Phone: (417) 820-2829
Fax: (417) 820-8852
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | R9148 | Missouri |
Profile Details
| NPI number | 1851437677 |
|---|---|
| LBN Legal business name | Bagby, Jack M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | May 1st, 2013 - about 13 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 | 1851437677 | NPPES |
| Missouri | MEDICAID | 200857019 | |
| Missouri | Other | P00006101 |
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