Provider Demographics
NPI:1003054008
Name:FLAGLER, SAMUEL (NMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:FLAGLER
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6737 E CAMINO PRINCIPAL
Mailing Address - Street 2:#C
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3910
Mailing Address - Country:US
Mailing Address - Phone:520-721-8821
Mailing Address - Fax:
Practice Address - Street 1:6737 E CAMINO PRINCIPAL
Practice Address - Street 2:#C
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3910
Practice Address - Country:US
Practice Address - Phone:520-721-8821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ83-349175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath