MEDICARE: CARL MICHAEL SMAGULA MD

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
1	207L00000X	Anesthesiology Physician	M7532	ID

General Provider Information

NPI Number	:	1568414100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL MICHAEL SMAGULA MD

Provider Business Mailing Address
First Line	:	211 STEMWINDER LN
Second Line	:
City	:	JONESBOROUGH
State	:	TN
Zip	:	37659-5881
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 STEMWINDER LN
Second Line	:
City	:	JONESBOROUGH
State	:	TN
Zip	:	37659-5881
Country	:	US
Telephone Number	:	406-750-7379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	03/25/2025

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