Theodore T Wagner Iii, MD | |
11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN 46845-1714 | |
(260) 425-5400 | |
(260) 425-5417 |
Full Name | Theodore T Wagner Iii |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 30 Years |
Location | 11141 Parkview Plaza Dr Ste 325, Fort Wayne, Indiana |
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 |
---|---|---|---|
1831162791 | NPI | - | NPPES |
100081380 | Medicaid | IN | |
0748972 | Medicaid | OH | |
000000087512 | Other | IN | ANTHEM BC/BS |
200245650 | Medicaid | IN | |
2568556 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 01050471A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Parkview Regional Medical Center | Fort wayne, IN | Hospital |
Adams Memorial Hospital | Decatur, IN | Hospital |
Bluffton Regional Medical Center | Bluffton, IN | Hospital |
Parkview Huntington Hospital | Huntington, IN | Hospital |
Parkview Whitley Hospital | Columbia city, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Parkview Health System Inc | 2163336967 | 1192 |
Entity Name | Parkview Health System Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932130952 PECOS PAC ID: 2163336967 Enrollment ID: O20031117000288 |
Entity Name | Northeast Indiana Urology. P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619920295 PECOS PAC ID: 5395641914 Enrollment ID: O20031212000174 |
Mailing Address | Practice Location Address |
---|---|
Theodore T Wagner Iii, MD 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Theodore T Wagner Iii, MD 11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN 46845-1714 Ph: (260) 425-5400 |
Claire Aubrey, D.O Urology Medicare: Accepting Medicare Assignments Practice Location: 2512 E Dupont Rd Ste 110, Fort Wayne, IN 46825 Phone: 260-458-3045 Fax: 260-479-2947 | |
Dr. Sable Paige Locke, M.D. Urology Medicare: Medicare Enrolled Practice Location: 11141 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845 Phone: 260-425-5400 Fax: 260-425-5417 | |
Michael Rudoff, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 2512 E Dupont Rd Ste 110, Fort Wayne, IN 46825 Phone: 260-458-3045 Fax: 260-479-2947 | |
David L Pollifrone, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN 46845 Phone: 260-425-5400 Fax: 260-425-5417 | |
George W. Bowers, Urology Medicare: Not Enrolled in Medicare Practice Location: 12002 Haddington Court, Fort Wayne, IN 46814 Phone: 260-625-3872 Fax: 260-524-5390 | |
Donald A Urban, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 11141 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845 Phone: 260-482-8681 Fax: 260-969-0350 | |
Nathan John Locke, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 11141 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845 Phone: 260-425-5400 Fax: 260-425-5417 |