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Contact Information

ROBERT J WAGNER, MD
1 MEDICAL VILLAGE DR
EDGEWOOD, KY41017
 Phone: 859-301-8074
 Fax: 859-301-4945
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ROBERT J WAGNER · (Male)

NPI # 1124018072
Status Active
Credentials MD
Entity Individual
Enumeration date 10/24/2005
Last updated 06/26/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • KY License # 36850
  • OH License # 35.076987
  • KY Medicaid 64045016
  • OH Medicaid 2434011
Hospital affiliation(s)
  • ST ELIZABETH GRANT - (Critical Access)
    238 BARNES ROAD
    WILLIAMSTOWN, KY 41097
  • ST ELIZABETH MEDICAL CENTER NORTH - (Acute Care)
    1 MEDICAL VILLAGE DRIVE
    LAKESIDE PARK, KY 41017
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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