Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2008012510 | MO |
Y | 207P00000X | Emergency Physician | DR.0041662 | CO |
N | 207PE0004X | Emergency Medical Services | L4589 | TX |
NPI | 1154389856 |
---|---|
Provider Name | Scott W. Nagely |
First Address | Saint Louis, MO 63178-8009 |
Second Address | Keystone, CO 80435-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 08/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
153533803 | (05) | TX |
H66709 | (02) | TX |