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Organization

DAVID VAN WAGNER MD PC

Active
Other names
Wagner Ear, Nose & Throat
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID VAN WAGNER M.D. (PHYSICIAN)
(712) 234-8787
Entity
Organization

Contact information

Practice address
2730 PIERCE ST STE 204, SIOUX CITY, IA 51104-3764
(712) 234-8787
(712) 234-8777
Mailing address
1000 W 4TH ST STE 8, YANKTON, SD 57078-3700
(605) 655-1414
(605) 655-1420

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
09/27/2012
Last updated
11/05/2012
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