Wagner, Kurt B

Wagner, Kurt B is an individual health care provider with primary practice located at 1749 David Walker Dr , Tavares FL 32778-5745. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagner, Kurt B can be contacted via phone (352) 742-1760.

Contact Information

Primary practice address
1749 David Walker Dr Tavares FL 32778-5745
Fax: (352) 742-2604
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME36930 Florida

Profile Details

NPI number 1548202427
LBN Legal business name Wagner, Kurt B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Aug 9th, 2013 - about 12 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 1548202427 NPPES
Florida MEDICAID 066638600
Florida Other 35186
Florida Other 010053499

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