Individual
LENARD D WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 NORTH MAIN, LOVINGTON, NM 88260-2813
(575) 396-6611
(575) 396-0318
Mailing address
200 W LEA ST, HOBBS, NM 88240-5110
(575) 391-0270
(575) 391-0271
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
86-141
NM
208D00000X
General Practice Physician
CS00009180
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36954
—
NM
Enumeration date
06/22/2006
Last updated
01/24/2014
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