Healthcare Provider Details

I. General information

NPI: 1508853797
Provider Name (Legal Business Name): ARTHRITIS & OSTEOPOROSIS TREATMENT CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 KINGSLEY AVE
ORANGE PARK FL
32073-5130
US

IV. Provider business mailing address

2100 KINGSLEY AVE
ORANGE PARK FL
32073-5130
US

V. Phone/Fax

Practice location:
  • Phone: 904-276-0001
  • Fax: 904-276-5333
Mailing address:
  • Phone: 904-276-0001
  • Fax: 904-276-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME47366
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2017862
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9228833
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3343402
License Number StateFL

VIII. Authorized Official

Name: DR. ADAM WALKER BAGLEY
Title or Position: PHYSICIAN/PRESIDENT
Credential: MD
Phone: 904-276-0001