Organization
WAGONER MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WAGONER (ADMINISTRATOR)
(765) 566-3303
Entity
Organization
Contact information
Practice address
2016 W SYCAMORE, KOKOMO, IN 46901
(765) 566-3303
Mailing address
605 E 7TH STREET, BURLINGTON, IN 46915-0038
(765) 566-3351
(765) 566-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
04/23/2007
Last updated
05/15/2009
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