Individual
THAO N. WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
NAVAL HOSPITAL PENSACOLA, 6000 WEST HIGHWAY 98, PENSACOLA, FL 32512-0003
(850) 505-6532
Mailing address
NAVAL HOSPITAL PENSACOLA, 6000 WEST HIGHWAY 98, PENSACOLA, FL 32512-0003
(850) 505-6532
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A123521
CA
2085R0202X
Diagnostic Radiology Physician
ME 105302
FL
Other
Enumeration date
03/14/2006
Last updated
02/11/2022
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