Wagner, Thomas R
Wagner, Thomas R is an individual health care provider with primary practice located at 1032 E Sumner St , Hartford WI 53027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wagner, Thomas R can be contacted via phone (262) 673-2300.Contact Information
Primary practice address
1032 E Sumner St
Hartford WI 53027
Phone: (262) 673-2300
Fax: (262) 673-5894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 16172 | Wisconsin |
Profile Details
| NPI number | 1033226071 |
|---|---|
| LBN Legal business name | Wagner, Thomas R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1033226071 | NPPES |
| Wisconsin | MEDICAID | 30887100 |
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