Wagner, Jacob Timothy

Wagner, Jacob Timothy is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Wagner, Jacob Timothy can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Phone: (608) 782-7300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1303 Wisconsin

Profile Details

NPI number 1790304442
LBN Legal business name Wagner, Jacob Timothy
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2020
Last updated Jan 13th, 2023 - about last year

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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