# JEFFREY D. WAGNER, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wagner and Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609079607
- **Authorized official:** DR. JEFFREY D. WAGNER MD (PRESIDENT)
- **Authorized official phone:** (317) 621-2520

## Contact information

- **Practice address:** 8040 CLEARVISTA PKWY STE 570, INDIANAPOLIS, IN 46256-4673
- **Practice address phone:** (317) 621-2580
- **Practice address fax:** (317) 621-2580
- **Mailing address:** 8040 CLEARVISTA PKWY STE 570, INDIANAPOLIS, IN 46256-4673
- **Mailing address phone:** (317) 621-2580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/07/2007
- **Last updated:** 11/02/2021