Dr William D Wagner, DO | |
55 W Tietan St, Walla Walla, WA 99362-4445 | |
(509) 525-3720 | |
(509) 522-1592 |
Full Name | Dr William D Wagner |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 24 Years |
Location | 55 W Tietan St, Walla Walla, Washington |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871567941 | NPI | - | NPPES |
170959 | Other | WA | L&I |
8352478 | Medicaid | WA | |
P00002021 | Other | WA | RAIL ROAD MEDICARE |
227270 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OP00001866 (Washington) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence St Mary Medical Center Home Health | Walla walla, WA | Home health agency |
Walla Walla Community Hospice | Walla walla, WA | Hospice |
Providence St Mary Medical Center | Walla walla, WA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Privia Medical Group Washington Pllc | 2264320837 | 49 |
Entity Name | Privia Medical Group Washington Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780658419 PECOS PAC ID: 2264320837 Enrollment ID: O20040309000126 |
Mailing Address | Practice Location Address |
---|---|
Dr William D Wagner, DO 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 | Dr William D Wagner, DO 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 |
Kevin Jon Molander, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 | |
Dr. John Eric Moore, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 | |
Samuel Kirtley, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1592 | |
Nicole Siobhan Patching, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1111 S 2nd Ave, Walla Walla, WA 99362 Phone: 509-897-3700 Fax: 509-897-5575 | |
Barry Kellogg, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1120 W Rose St, Walla Walla, WA 99362 Phone: 509-525-6650 Fax: 509-522-2349 | |
Lehlia P Stanton, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 77 Wainwright Dr, Va Medical Center, Walla Walla, WA 99362 Phone: 509-527-3453 | |
Michael J Tacheny, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1120 W Rose St, Walla Walla, WA 99362 Phone: 509-525-6650 Fax: 509-522-2349 |