Wagnon, Michael A

Wagnon, Michael A is an individual health care provider with primary practice located at 225 E Beauregard Ave , San Angelo TX 76903-5920. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wagnon, Michael A can be contacted via phone (325) 658-1511.

Contact Information

Primary practice address
225 E Beauregard Ave San Angelo TX 76903-5920
Phone: (325) 658-1511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X K7486 Texas

Profile Details

NPI number 1992795645
LBN Legal business name Wagnon, Michael A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Nov 22nd, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992795645 NPPES
Texas MEDICAID 142727001

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