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Contact Information

JAN GILLESPIE WAGNER, MD
1175 58TH AVE
STE 200
GREELEY, CO80634-4807
 Phone: 970-495-0444
 Fax: 970-488-3106
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JAN GILLESPIE WAGNER · (Female)

NPI Number 1043293921
Status Active
Credentials MD
Entity Individual
Enumeration date 11/23/2005
Last updated 11/30/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 26768
  • CO Medicaid 01267681
  • WY Medicaid 102189300
  • Other 187075800 DEPARTMENT OF LABOR
  • CO Other GI160818 ANTHEM BCBS
Hospital affiliation(s) Not Available
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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