Bagley, Jacob

Bagley, Jacob is an individual health care provider with primary practice located at 2801 W Kinnickinnic River Pkwy Ste 680 , Milwaukee WI 53215-3633. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Bagley, Jacob can be contacted via phone (414) 385-1922.

Contact Information

Primary practice address
2801 W Kinnickinnic River Pkwy Ste 680 Milwaukee WI 53215-3633
Phone: (414) 385-1922
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X MD205373 Oregon
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X A179465 California
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 81849 Wisconsin
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 81849 Wisconsin

Profile Details

NPI number 1447678172
LBN Legal business name Bagley, Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2014
Last updated Aug 24th, 2026 - about 2 months 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1447678172 NPPES
Wisconsin MEDICAID 1000248086

Popular Providers