Dr DOUGLAS LEE WAGONER is a male medical professional, specializing in Family Medicine. He graduated in 1978 from University Of Iowa College Of Medicine.
GLENCOE REGIONAL HEALTH SERVICES
1805 HENNEPIN AVE N
GLENCOE
MN
553361416
Tel: 3208643121
| Npi | 1225027162 |
| Pac Id | 4486566965 |
| Professional Enrollment Id | I20100215000796 |
| Last Name | WAGONER |
| First Name | DOUGLAS |
| Middle Name | LEE |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 1978 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | GLENCOE REGIONAL HEALTH SERVICES |
| Group Practice Pac Id | 1759292980 |
| Number Of Group Practice Members | 34 |
| Line 1 Street Address | 1805 HENNEPIN AVE N |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | GLENCOE |
| State | MN |
| Zip Code | 553361416 |
| Phone Number | 3208643121 |
| Hospital Affiliation Ccn 1 | 241355 |
| Hospital Affiliation Lbn 1 | GLENCOE REGIONAL HEALTH SERVICES |
| Hospital Affiliation Ccn 2 | 240056 |
| Hospital Affiliation Lbn 2 | RIDGEVIEW MEDICAL CENTER |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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