Whalio Doctors

NPI 1093743502

Brian Keith Wagner, DPM

Practitioner Foot Surgery Podiatrist Farmington, CT

Practice location

Address
11 South Rd Lowr Level20, Farmington, CT 06032-2483
Phone
(860) 470-5703
Fax
(860) 606-8025
Mailing address
11 South Road Lower Level 20, Farmington, CT 06032

Registered specialties (4)

Foot Surgery Podiatrist Primary
Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0131X Licence 000793 (CT)
Podiatrist
Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 000793 (CT)
Radiology Podiatrist
Podiatric Medicine & Surgery Service Providers Taxonomy 213ER0200X Licence 000793 (CT)
Foot & Ankle Surgery Podiatrist
Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 000862 (CT)

Registry record

NPI
1093743502
Entity type
Individual
Sex (as registered)
Male
NPI issued
30 Jun 2006
Record last updated
20 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.