Waggoner, Michael

Waggoner, Michael is an individual health care provider with primary practice located at 3737 W Walnut St , Rogers AR 72756-1839. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Waggoner, Michael can be contacted via phone (479) 246-1700.

Contact Information

Primary practice address
3737 W Walnut St Rogers AR 72756-1839
Phone: (479) 246-1700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 5341 Oklahoma
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X E-8612 Arkansas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X T2009017030 Missouri

Profile Details

NPI number 1295963999
LBN Legal business name Waggoner, Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2009
Last updated Jun 14th, 2022 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1295963999 NPPES
Oklahoma MEDICAID 200493810A

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