Individual
JOHN FRANCIS WAGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35.133649
OH
207RI0011X
Interventional Cardiology Physician
Primary
11931
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972879161
—
ND
Enumeration date
04/01/2012
Last updated
07/30/2020
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