Rg Wagner Md Llc

LBN: Rg Wagner Md Llc
Rg Wagner Md Llc is an health care organization with primary practice located at 2160 Fountain Dr Suite D, Snellville GA 30078-7022. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Rg Wagner Md Llc can be contacted via phone (770) 982-7790, or through Wagner, Russell G via phone (770) 982-7790.

Contact Information

Primary practice address
2160 Fountain Dr Suite D Snellville GA 30078-7022
Phone: (770) 982-7790
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wagner, Russell G
Phone: (770) 982-7790

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1548275415
LBN Legal business name Rg Wagner Md Llc
DBA Doing business as
Authorized official Wagner, Russell G
Entity Organization
Organization subpart 1 No
Enumeration date Jul 29th, 2006
Last updated Jul 20th, 2009 - about 16 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 1548275415 NPPES
Georgia MEDICAID 000418074E

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