Organization
LOIS WAGSTROM M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOIS WAGSTROM M.D. (OWNER)
(615) 329-1822
Entity
Organization
Contact information
Practice address
250 25TH AVE N, SUITE 301, NASHVILLE, TN 37203-1632
(615) 329-1822
(615) 327-3206
Mailing address
250 25TH AVE N, SUITE 301, NASHVILLE, TN 37203-1632
(615) 329-1822
(615) 327-3206
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MDO21252
TN
Other
Enumeration date
06/30/2008
Last updated
08/11/2008
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