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Contact Information

JEFFREY D WAGNER, MD
8040 CLEARVISTA PKWY STE 520
INDIANAPOLIS, IN46256-5604
 Phone: 317-621-9470
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JEFFREY D WAGNER · (Male)

NPI # 1881690790
Status Active
Credentials MD
Entity Individual
Enumeration date 06/24/2005
Last updated 09/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01041504
  • IN License # 01041504A
  • IN Medicaid 100347810
Hospital affiliation(s)
  • COMMUNITY HOSPITAL EAST - (Acute Care)
    1500 N RITTER AVE
    INDIANAPOLIS, IN 46219
  • COMMUNITY HOSPITAL NORTH - (Acute Care)
    7150 CLEARVISTA DR
    INDIANAPOLIS, IN 46256
  • COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY - (Acute Care)
    1515 N MADISON AVE
    ANDERSON, IN 46011
  • COMMUNITY HOSPITAL SOUTH - (Acute Care)
    1402 E COUNTY LINE RD S
    INDIANAPOLIS, IN 46227
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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