Individual
DR. WAME NICHOLAS WAGGENSPACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8080 BLUEBONNET BLVD, SUITE 1000, BATON ROUGE, LA 70810-7827
(225) 924-2424
(225) 408-7984
Mailing address
8080 BLUEBONNET BLVD, SUITE 1000, BATON ROUGE, LA 70810-7827
(225) 924-2424
(225) 408-7984
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19439
MS
207P00000X
Emergency Medicine Physician
201531
LA
207QS0010X
Sports Medicine (Family Medicine) Physician
19439
MS
207QS0010X
Sports Medicine (Family Medicine) Physician
201531
LA
207X00000X
Orthopaedic Surgery Physician
Primary
201531
LA
207X00000X
Orthopaedic Surgery Physician
L9952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04476300
—
MS
05
—
1018236
—
LA
Enumeration date
07/17/2006
Last updated
02/26/2025
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