Wagner, Richard Alan
Wagner, Richard Alan is an sole proprietor health care provider with primary practice located at 350 W Columbia St Ste 450, Evansville IN 47710-5610. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagner, Richard Alan can be contacted via phone (812) 425-1596.Contact Information
Primary practice address
350 W Columbia St Ste 450
Evansville IN 47710-5610
Phone: (812) 425-1596
Fax: (812) 425-0799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01025468 | Indiana |
Profile Details
| NPI number | 1619973179 |
|---|---|
| LBN Legal business name | Wagner, Richard Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jun 13th, 2008 - about 16 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 | 1619973179 | NPPES |
| Indiana | MEDICAID | 100242040A |
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