Individual
JACOB LEVI WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 DELHI ST, SUITE 200, DUBUQUE, IA 52001-6320
(563) 557-7000
(563) 589-4050
Mailing address
1515 DELHI ST, SUITE 200, DUBUQUE, IA 52001-6320
(563) 557-7000
(563) 589-4050
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37907
IA
Other
Enumeration date
10/05/2006
Last updated
10/14/2020
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