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Contact Information

TOM L WAGNER
509 MAIN ST
DR TOM L WAGNER
MURRAY, KY42071
 Phone: 270-759-1210
 Fax: 270-753-6210
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for TOM L WAGNER · (Male)

NPI # 1043233919
Status Active
Credentials
Entity Individual
Enumeration date 07/25/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • KY License # KY319
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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