DR. GROVER CARLTON BAGBY MD NPI 1962599910

NPI Information

NPI: 1962599910
Provider Name: DR. GROVER CARLTON BAGBY, MD
Classification: Internal Medicine - 207RH0000X
Entity Type: Individual

Specialization: Hematology

Address:
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-6594
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DR. Grover Carlton Bagby, MD is a hematology internal medicine in Portland, OR. The provider is an internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. DR. Grover Carlton Bagby, MD NPI is 1962599910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-6594

The enumeration date for this NPI number is 10/9/2006 and was last updated on 1/29/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RH0000X	Internal Medicine	Hematology	MD07879	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	130248	MEDICAID	OREGON
2	C92126	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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