Bagley, Jacob

Bagley, Jacob is an individual health care provider with primary practice located at 300 Pasteur Dr , Stanford CA 94305-2200. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Bagley, Jacob can be contacted via phone (650) 723-4000.

Contact Information

Primary practice address
300 Pasteur Dr Stanford CA 94305-2200
Phone: (650) 723-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X A179465 California
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X MD205373 Oregon
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 Oct 18th, 2023 - about 3 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 1447678172 NPPES
Wisconsin MEDICAID 1000248086

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