Individual provider · Type 1 NPI

Brett Gerald Bagley, P.A. - CERTIFIED

Medical Physician Assistant · Rexburg, ID

NPI number 1932254133 Active

Practice location

556 Trejo St, Suite B
Rexburg, ID 83440

Call (208) 359-2263 Map

Fax (208) 359-2042

Mailing address

534 Trejo St Ste 400
Rexburg, ID 83440-5405

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-215 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1932254133

Brett Gerald Bagley, P.A. - CERTIFIED's National Provider Identifier is 1932254133, issued on Jan 25, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rexburg, ID. The record was last updated on Jun 26, 2018.