Individual
COURTNEY REGAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
931 HIGHLAND BLVD STE 3130, BOZEMAN, MT 59715-6914
(406) 414-5070
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5070
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
89785
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205092400
—
MT
Enumeration date
08/06/2008
Last updated
04/09/2025
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