National Provider Identifier Database

BRIAN K WAGNER, DPM – NPI #1093743502
Surgery, Foot


Contact Information

BRIAN K WAGNER, DPM
11 SOUTH RD LOWR LEVEL20
FARMINGTON, CT06032-2483
Phone: 860-470-5703
Fax: 860-606-8025
Website:
Specialty Taxonomy Code
* Surgery, Foot 213ES0131X
Podiatrist 213E00000X
Radiology 213ER0200X
Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for BRIAN K WAGNER

NPI Number 1093743502
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/30/2006
Last updated 08/20/2020 - About 6 years ago
Sole proprietor1 No
Identifiers
  • CT License #: 000793
  • CT License #: 000862
Hospital affiliation n/a

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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