Wagner, James Blake

Wagner, James Blake is an individual health care provider with primary practice located at 1525 Country Club Rd , Sherwood AR 72120-5076. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is his primary health care specialty. Wagner, James Blake can be contacted via phone (501) 978-3135.

Contact Information

Primary practice address
1525 Country Club Rd Sherwood AR 72120-5076
Phone: (501) 978-3135
Fax: (501) 978-3138
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X PT2565 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT2565 Arkansas

Profile Details

NPI number 1306804448
LBN Legal business name Wagner, James Blake
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Mar 11th, 2014 - about 11 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 1306804448 NPPES
Arkansas Other 5W797C153 AR BLUE CROSS BLUE SHIELD

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