Physician Compare National (NPI:1215462932)

HEALTHCARE PROVIDER: BLAKE BAGGETT D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1215462932
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648537464
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171204002947
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAGGETT
	Individual professional last name
Provider First Name	BLAKE
	Individual professional first name
Provider Middle Name	ANTHONY
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LIFE CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	917 MCFARLAND BLVD
	Group Practice or individual's line 1 address
City	NORTHPORT
	Group Practice or individual's city
State	AL
	Group Practice or individual's state
Zip Code	354763373
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M