Individual
CHRISTY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1856-14 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1663
(770) 534-2800
(770) 534-2889
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
050067
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000907409B
—
GA
Enumeration date
08/23/2005
Last updated
10/13/2020
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