Provider Demographics
NPI:1316057714
Name:NAGLE, THOMAS MICHAEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:NAGLE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 N THUNDERBIRD CIR STE 303
Mailing Address - Street 2:NEXTCARE URGENT CARE
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1219
Mailing Address - Country:US
Mailing Address - Phone:480-353-2235
Mailing Address - Fax:480-776-0025
Practice Address - Street 1:2080 W. SOUTHERN AVE
Practice Address - Street 2:STE A1
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-7653
Practice Address - Country:US
Practice Address - Phone:480-985-0172
Practice Address - Fax:480-985-0173
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005053363AS0400X
AZ2828363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA10005053OtherSTATE LICENSE
WAPA10005053OtherSTATE LICENSE
75942Medicare ID - Type Unspecified