Mr William Wallace Waggoner, PT | |
500 Sagamore Pkwy W Ste 2w, West Lafayette, IN 47906-1459 | |
(765) 250-9660 | |
Not Available |
Full Name | Mr William Wallace Waggoner |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 27 Years |
Location | 500 Sagamore Pkwy W Ste 2w, West Lafayette, 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 |
---|---|---|---|
1255368049 | NPI | - | NPPES |
000000527519 | Other | IN | ANTHEM PROVIDER NUMBER |
200307360 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 05006050A (Indiana) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Team Rehabilitation Services Llc | 2264479518 | 529 |
Provider Name | Team Rehabilitation In09, Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1700319712 PECOS PAC ID: 5698042471 Enrollment ID: O20170526000931 |
Provider Name | Team Rehabilitation Services Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790455046 PECOS PAC ID: 2264479518 Enrollment ID: O20211026003156 |
Mailing Address | Practice Location Address |
---|---|
Mr William Wallace Waggoner, PT 33900 Harper Ave Ste 104, Clinton Twp, MI 48035-4258 Ph: (586) 350-2644 | Mr William Wallace Waggoner, PT 500 Sagamore Pkwy W Ste 2w, West Lafayette, IN 47906-1459 Ph: (765) 250-9660 |
Jessica Stipp, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1700 Lindberg Rd, West Lafayette, IN 47906 Phone: 765-464-5600 | |
Randous Bowens, Physical Therapist Medicare: Medicare Enrolled Practice Location: 257 Sagamore Pkwy W, Suite 230, West Lafayette, IN 47906 Phone: 765-463-2200 | |
Lawrence Dantae Robertson, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2136 Cumulus Ct, West Lafayette, IN 47906 Phone: 706-267-9773 | |
Kirstin Lestinsky, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1044 Sagamore Pkwy W Unit A, West Lafayette, IN 47906 Phone: 765-250-4445 | |
Rachel Wichlinski, Physical Therapist Medicare: Medicare Enrolled Practice Location: 2741 N Salisbury St, West Lafayette, IN 47906 Phone: 765-463-7546 | |
Garrett R Buechler, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1044 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-250-4445 Fax: 765-463-7664 | |
Kirsten Zambon, PT, DPT, CLT Physical Therapist Medicare: Medicare Enrolled Practice Location: 909 Sagamore Pkwy W Ste 917, West Lafayette, IN 47906 Phone: 765-463-0710 Fax: 765-463-0711 |