Wagner, John Thomas

Wagner, John Thomas is an individual health care provider with primary practice located at 819 Mount Royal Blvd , Pittsburgh PA 15223-1244. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Wagner, John Thomas can be contacted via phone (412) 492-9006.

Contact Information

Primary practice address
819 Mount Royal Blvd Pittsburgh PA 15223-1244
Phone: (412) 492-9006
Fax: (412) 492-0938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC003667R Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC003667R Pennsylvania

Profile Details

NPI number 1821098351
LBN Legal business name Wagner, John Thomas
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2005
Last updated Jun 15th, 2010 - about 14 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 1821098351 NPPES
Pennsylvania MEDICAID 001408328009

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