Trevor John Wagner in Omaha - Sports Physician
Trevor John Wagner - NPI 1740229566
Trevor John Wagner is a Sports Physician in Omaha, Nebraska. Trevor John Wagner practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Trevor John Wagner is 1740229566. The last update date is 2007-07-08.
Trevor John Wagner's current location address is 6411 S 172nd Ave, Omaha, Nebraska. You can contact this provider via phone number 4028911249 and fax number 4023340891. The mailing address for Trevor John Wagner is 6411 S 172nd Ave, Omaha, Nebraska. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Trevor John Wagner |
|---|---|
| Address | 6411 S 172nd Ave, Omaha, Nebraska |
| Phone Number | 4028911249 |
| Fax Number | 4023340891 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1740229566 |
|---|---|
| Provider Enumeration Date | 2006-06-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 6411 S 172nd Ave |
|---|---|
| City | Omaha |
| State | Nebraska (NE) |
| Post Code | 681353080 |
| Phone Number | 4028911249 |
| Fax Number | 4023340891 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 1125 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36615 | NE | BLUE CROSS/BLUE SHIELD | |
| 47-0802260 05 | NE | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Trevor John Wagner by the Centers for Medicare & Medicaid Services?
The Trevor John Wagner has been assigned the NPI (National Provider Identifier) 1740229566 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Trevor John Wagner?
The Trevor John Wagner is physically situated at 6411 S 172Nd Ave, in the city of Omaha, state of NE, with the postal code 681353080.
What is Trevor John Wagner's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Trevor John Wagner is Sports Physician, and the corresponding taxonomy classification code for this specialized field is 111Ns0005X.
On what date did the Centers for Medicare & Medicaid Services assign the 1740229566 to Trevor John Wagner?
The Centers for Medicare & Medicaid Services assigned the 1740229566 to Trevor John Wagner on 2006-06-06.
When was the information regarding Trevor John Wagner, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Trevor John Wagner, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.