Individual
PHILIP L WACKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
107551
MN
2080P0202X
Pediatric Cardiology Physician
13518
ND
2080P0202X
Pediatric Cardiology Physician
57540
AZ
2080P0202X
Pediatric Cardiology Physician
Primary
58258
MN
Other
Enumeration date
06/21/2007
Last updated
02/25/2025
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