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General NPI Number Information
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NPI Number | 1316057714
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Entity Type | Individual
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Provider Name | THOMAS MICHAEL NAGLE PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 2080 W. SOUTHERN AVE STE A1
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-7653
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Country | US
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Telephone | 480-985-0172
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Fax | 480-985-0173
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Provider Business Mailing Address
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Address Line | 2550 N THUNDERBIRD CIR STE 303 NEXTCARE URGENT CARE
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City | MESA
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State | AZ
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Zip | 85215-1219
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Country | US
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Telephone | 480-353-2235
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Fax | 480-776-0025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA10005053
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2828
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License Number State | AZ
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