Individual
THOMAS E WAGGONER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2404 E RIVER RD STE 100, TUCSON, AZ 85718-6521
(520) 838-2148
Mailing address
3375 N CAMPBELL AVE, TUCSON, AZ 85719-2306
(520) 838-2148
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
006643
AZ
207RC0000X
Cardiovascular Disease Physician
25MB09443300
NJ
207RC0000X
Cardiovascular Disease Physician
OS11212
FL
207RI0011X
Interventional Cardiology Physician
Primary
006643
AZ
Other
Enumeration date
07/11/2011
Last updated
07/11/2016
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