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Contact Information

JESSICA H WAGENER, MD
115 PORTER DRIVE
PORTER HOSPITAL
MIDDLEBURY, VT05753
 Phone: 802-388-4001
 Fax: 802-388-5612
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JESSICA H WAGENER · (Female)

NPI Number 1023180445
Status Active
Credentials MD
Entity Individual
Enumeration date 11/14/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • VT License # 0420008940
  • VT Medicaid 0VN0884
  • VT Other 19935 BCBS
  • VT Other 77V131 MVP VT MGD CARE
Hospital affiliation(s)
  • PORTER HOSPITAL INC - (Critical Access)
    115 PORTER DRIVE
    MIDDLEBURY, VT 05753
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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