Individual
DR. PAUL FRANCIS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
308 MCHENRY ST, BURLINGTON, WI 53105
(262) 763-7613
(262) 763-7002
Mailing address
308 MCHENRY ST, BURLINGTON, WI 53105
(262) 763-7613
(262) 763-7002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16912
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31168200
—
WI
05
—
65235
—
WI
Enumeration date
09/02/2006
Last updated
10/29/2012
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