Provider Demographics
NPI:1932162310
Name:BAGNELL, KAREN G
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:G
Last Name:BAGNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:1014 CEDAR LANE
Mailing Address - City:WYCOMBE
Mailing Address - State:PA
Mailing Address - Zip Code:18980-0286
Mailing Address - Country:US
Mailing Address - Phone:215-504-2711
Mailing Address - Fax:
Practice Address - Street 1:301 CORPORATE DR E
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8009
Practice Address - Country:US
Practice Address - Phone:215-504-2711
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005643L111N00000X
FLCH6887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2533774OtherAETNA HMO
PA7354343OtherAETNA PPO
PA892911OtherHIGHMARK BLUE SHIELD
PA0141728000OtherINDEPEND. BLUE CROSS
PA2533774OtherAETNA HMO
PA892911OtherHIGHMARK BLUE SHIELD