Individual
TOMMY W WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3644 W ST HWY 18, MANILA, AR 72442
(870) 561-3300
(870) 561-3307
Mailing address
PO BOX 910, MANILA, AR 72442
(870) 561-3300
(870) 561-3307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3873
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156106001
—
AR
Enumeration date
12/01/2005
Last updated
02/20/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us