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NPI Code Detail

MEDICARE: ANNA COOPER BAGBY M.D.

MEDICARE: ANNA COOPER BAGBY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician58181CO

General Provider Information

NPI Number : 1295122406
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA COOPER BAGBY M.D.
Provider Business Mailing Address
First Line : 1107 S LEMAY AVE STE 200
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3959
Country : US
Telephone Number : 970-484-1757
Fax Number : 970-484-9924
Provider Business Practice Location Address
First Line : 1107 S LEMAY AVE STE 200
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3959
Country : US
Telephone Number : 970-484-1757
Fax Number : 970-484-9924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2015
Last Update Date : 10/04/2021

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Directions to “ ANNA COOPER BAGBY M.D.” Practice Location

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