Individual
JEFFREY RYAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DR.0070490
CO
208M00000X
Hospitalist Physician
Primary
DR.0070490
CO
Other
Enumeration date
04/14/2019
Last updated
06/22/2023
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