Waggoner, Daniel Leroy

Waggoner, Daniel Leroy is an individual health care provider with primary practice located at 23 Clara Dr Suite 204, Mystic CT 06355-1959. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Waggoner, Daniel Leroy can be contacted via phone (860) 536-2995.

Contact Information

Primary practice address
23 Clara Dr Suite 204 Mystic CT 06355-1959
Phone: (860) 536-2995
Fax: (860) 572-0265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 045087 Connecticut
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 45087 Connecticut

Profile Details

NPI number 1558406066
LBN Legal business name Waggoner, Daniel Leroy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Mar 25th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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