| Wagoner Medical Group Pc | |
|
800 N Alpha St Grand Island NE 68803-4320 | |
| (308) 382-2010 | |
| (308) 382-9549 |
| Full Name | Wagoner Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 N Alpha St, Grand Island, Nebraska |
| Authorized Official Name and Position | Jody M Hughes (OFFICE MANAGER) |
| Authorized Official Contact | 3083822010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagoner Medical Group Pc 800 N Alpha St Grand Island NE 68803-4320 Ph: (308) 382-2010 | Wagoner Medical Group Pc 800 N Alpha St Grand Island NE 68803-4320 Ph: (308) 382-2010 |
| NPI Number | 1013964162 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 02/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013964162 | NPI | - | NPPES |
| CD3724 | Other | NE | MEDICARE GROUP RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Nebraska) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (Nebraska) | Secondary |
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