Dr John A Wagoner, MD | |
800 N Alpha St, Grand Island, NE 68803-4320 | |
(308) 382-2010 | |
(308) 382-9549 |
Full Name | Dr John A Wagoner |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 800 N Alpha St, Grand Island, Nebraska |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114974284 | NPI | - | NPPES |
47071903800 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 14621 (Nebraska) | Primary |
Entity Name | Wagoner Medical Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013964162 PECOS PAC ID: 0941398515 Enrollment ID: O20071115000064 |
Mailing Address | Practice Location Address |
---|---|
Dr John A Wagoner, MD 800 N Alpha St, Grand Island, NE 68803-4320 Ph: (308) 382-2010 | Dr John A Wagoner, MD 800 N Alpha St, Grand Island, NE 68803-4320 Ph: (308) 382-2010 |
Dr. Niraj Kumar Yadav, MBBS Internal Medicine Medicare: Medicare Enrolled Practice Location: 2620 W Faidley Ave, Grand Island, NE 68803 Phone: 308-384-4600 | |
Dr. Nathan William Murdoch, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3610 Richmond Cir Ste 100, Grand Island, NE 68803 Phone: 308-398-6400 Fax: 308-398-6408 | |
Dr. Clayton Jose Friesen, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3515 Richmond Circle, Grand Island, NE 68803 Phone: 308-381-8636 Fax: 308-381-8622 | |
Dr. Ghulam R. Mirza, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 2201 N Broadwell Ave, Grand Island, NE 68803 Phone: 308-382-3660 | |
Swathi Lavudi, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3563 Prairieview St Ste 200, Grand Island, NE 68803 Phone: 308-382-2010 Fax: 308-382-9549 | |
Dr. Jeffrey K. King, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3515 Richmond Circle, Grand Island, NE 68803 Phone: 308-381-8636 Fax: 308-381-8622 |