Individual
DR. JOHN G WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5149 N 9TH AVE, SUITE 120, PENSACOLA, FL 32504-8734
(850) 477-9253
(850) 494-9843
Mailing address
5149 N 9TH AVE, SUITE 120, PENSACOLA, FL 32504-8734
(850) 477-9253
(850) 494-9843
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME0076654
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME0076654
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254788100
—
FL
Enumeration date
12/13/2005
Last updated
04/11/2011
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