Individual provider · Type 1 NPI

Evan James Bagwell

Student in an Organized Health Care Education/Training Program · Athens, GA

NPI number 1164904264 Active

Practice location

330 River Rd
Athens, GA 30602-1538

Call (864) 934-7523 Map

Mailing address

153 Massey Rd
Piedmont, SC 29673-9056

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1164904264

Evan James Bagwell's National Provider Identifier is 1164904264, issued on Sep 5, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Athens, GA. The record was last updated on Sep 5, 2018.