Free National NPI Number Registry

Dr. William Robert Wagner

Home >Dr. William Robert Wagner

 

NPI Number Detailed Information

Provider Information:

Name: Dr. William Robert Wagner
Gender: M
Provider License Number If Given: R055430

NPI Information:

NPI: 1043219587
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 4/29/2016

Provider Business Mailing Address:

Address: 1000 HEALTH CENTER ROAD KYLE HEALTH CENTER / DHHS/IHS
Kyle, SD 57752
Phone Number: 9176269011
Fax Number:

Provider Business Practice Location Address:

Address: 1000 HEALTH CENTER ROAD KYLE HEALTH CENTER / DHHS/IHS
Kyle, SD 57752
Phone Number: 9176269011
Fax Number:

Provider Taxonomy:

Primary: 1041C0700X
Secondary (if any): 163W00000X
State: SD