Douglas Lee Wagoner in Glencoe - Family Medicine
Douglas Lee Wagoner - NPI 1225027162
Douglas Lee Wagoner is a Family Medicine in Glencoe, Minnesota. Douglas Lee Wagoner practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Douglas Lee Wagoner is 1225027162. The last update date is 2020-11-25.
Douglas Lee Wagoner's current location address is 1805 Hennepin Ave N, Glencoe, Minnesota. You can contact this provider via phone number 3208643121 and fax number 3208647887. The mailing address for Douglas Lee Wagoner is 1805 Hennepin Ave N, Glencoe, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Douglas Lee Wagoner |
|---|---|
| Address | 1805 Hennepin Ave N, Glencoe, Minnesota |
| Phone Number | 3208643121 |
| Fax Number | 3208647887 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1225027162 |
|---|---|
| Provider Enumeration Date | 2005-10-13 |
| Last Updated Date | 2020-11-25 |
Provider Mailing Address Detail
| Address | 1805 Hennepin Ave N |
|---|---|
| City | Glencoe |
| State | Minnesota (MN) |
| Post Code | 553361416 |
| Phone Number | 3208643121 |
| Fax Number | 3208647887 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 27782 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 24767000 | MN | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Douglas Lee Wagoner by the Centers for Medicare & Medicaid Services?
The Douglas Lee Wagoner has been issued the NPI (National Provider Identifier) 1225027162 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Douglas Lee Wagoner located?
The Douglas Lee Wagoner is located at 1805 Hennepin Ave N, Glencoe, MN 553361416.
What is Douglas Lee Wagoner's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Douglas Lee Wagoner is Family Medicine, and the corresponding taxonomy classification code for this specialized field is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1225027162 to Douglas Lee Wagoner?
The Centers for Medicare & Medicaid Services originally issued the 1225027162 to Douglas Lee Wagoner on 2005-10-13.
As of what date were the details pertaining to Douglas Lee Wagoner last refreshed?
The information related to the Douglas Lee Wagoner, including its address, specialty, and other relevant details, was last updated on 2020-11-25.
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