Wagner, Philip L
Wagner, Philip L is an individual health care provider with primary practice located at 2301 House Ave Suite 400, Cheyenne WY 82001-3176. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Wagner, Philip L can be contacted via phone (307) 634-5216.Contact Information
Primary practice address
2301 House Ave Suite 400
Cheyenne WY 82001-3176
Phone: (307) 634-5216
Fax: (307) 638-6675
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 5171A | Wyoming |
Profile Details
| NPI number | 1740201276 |
|---|---|
| LBN Legal business name | Wagner, Philip L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Jul 21st, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740201276 | NPPES |
| Wyoming | MEDICAID | 104211400 |
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