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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 Specialty Code Provider Type

Surgery, Foot

213ES0131X 48 Podiatry
 

Podiatrist

213E00000X 48 Podiatry
 

Radiology

213ER0200X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRIAN K WAGNER · (Male)

NPI Number 1093743502
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/30/2006
Last updated 08/20/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 000793
  • CT License # 000862
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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