Dr BRIAN G WAGONER is a male medical professional, specializing in Nurse Practitioner. He graduated in 2008.
MERCY CLINIC SPRINGFIELD COMMUNITIES
1235 E CHEROKEE ST
MC RADIOLOGY SPRINGFIELD
SPRINGFIELD
MO
658042203
Tel: 4178209729
| Npi | 1306083480 |
| Pac Id | 2860542693 |
| Professional Enrollment Id | I20090616000649 |
| Last Name | WAGONER |
| First Name | BRIAN |
| Middle Name | G |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2008 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | MERCY CLINIC SPRINGFIELD COMMUNITIES |
| Group Practice Pac Id | 7416865845 |
| Number Of Group Practice Members | 933 |
| Line 1 Street Address | 1235 E CHEROKEE ST |
| Line 2 Street Address | MC RADIOLOGY SPRINGFIELD |
| Marker Of Address Line 2 Suppression | |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 658042203 |
| Phone Number | 4178209729 |
| Hospital Affiliation Ccn 1 | 260065 |
| Hospital Affiliation Lbn 1 | MERCY HOSPITAL SPRINGFIELD |
| Hospital Affiliation Ccn 2 | 260040 |
| Hospital Affiliation Lbn 2 | COX MEDICAL CENTERS |
| 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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