Individual
DR. ALAN L WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1309 S JACKSON ST, FRANKFORT, IN 46041-3314
(765) 656-3401
(765) 656-3415
Mailing address
1309 S JACKSON ST, FRANKFORT, IN 46041-3314
(765) 656-3401
(765) 656-3415
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01033827A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100195340A
—
IN
Enumeration date
11/02/2005
Last updated
03/13/2013
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