| Douglas Lee Wagoner, MD | |
|
1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336-1416 | |
| (320) 864-3121 | |
| (320) 864-7887 |
| Full Name | Douglas Lee Wagoner |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1805 Hennepin Ave N, Glencoe, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225027162 | NPI | - | NPPES |
| 024767000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27782 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Lee Wagoner, MD 1805 Hennepin Ave N, Glencoe, MN 55336-1416 Ph: (320) 864-3121 | Douglas Lee Wagoner, MD 1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336-1416 Ph: (320) 864-3121 |
Timothy F Lane, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 | |
Michael Patrick Mccarthy, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
James W Jessen, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1805 Hennepin Ave N, Glencoe, MN 55336 Phone: 320-864-3121 | |
Laura Jean Olson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1805 Hennepin Ave North, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
Kristine Leonard Knudten, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1805 Hennepin Ave North, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 | |
Bryan Tutt Petersen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1805 Hennepin Ave N, Glencoe Regional Health Services, Glencoe, MN 55336 Phone: 320-864-3121 Fax: 320-864-7887 |