Individual
BEAU E WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 11TH ST, HAWARDEN, IA 51023-1903
(712) 551-3100
(712) 551-3177
Mailing address
1111 11TH ST, HAWARDEN, IA 51023-1903
(712) 551-3100
(712) 551-3177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
62893-20
WI
207Q00000X
Family Medicine Physician
Primary
MD-43267
IA
Other
Enumeration date
09/25/2014
Last updated
08/18/2016
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