Kendall D. Wagner, M.D., Pllc

LBN: Kendall D. Wagner, M.D., Pllc
Kendall D. Wagner, M.D., Pllc is an health care organization with primary practice located at 11300 Roberts Blvd , Fort Smith AR 72916-6027. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Kendall D. Wagner, M.D., Pllc can be contacted via phone (000) 000-0000, or through Wagner, Kendall Darren via phone (501) 766-6311.

Contact Information

Primary practice address
11300 Roberts Blvd Fort Smith AR 72916-6027
Phone: (000) 000-0000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wagner, Kendall Darren Doctor of Medicine (MD)
Phone: (501) 766-6311

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1528721271
LBN Legal business name Kendall D. Wagner, M.D., Pllc
DBA Doing business as
Authorized official Wagner, Kendall Darren Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2021
Last updated Oct 20th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528721271 NPPES
Arkansas MEDICAID 202855001

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