Wagner, Carl
Wagner, Carl is an individual health care provider with primary practice located at 907 E Lamar Alexander Pkwy , Maryville TN 37804-5015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wagner, Carl can be contacted via phone (865) 983-7211.Contact Information
Primary practice address
907 E Lamar Alexander Pkwy
Maryville TN 37804-5015
Phone: (865) 983-7211
Fax: (865) 450-9374
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 19646 | Tennessee |
Profile Details
| NPI number | 1558352856 |
|---|---|
| LBN Legal business name | Wagner, Carl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Dec 2nd, 2010 - 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 | 1558352856 | NPPES |
| Tennessee | MEDICAID | 3863943 | |
| Tennessee | Other | 4013852 |
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