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Contact Information

PATRICK A WAGNER PHD PC
1253 NORTH DEER RUN E DRIVE
SHELBYVILLE, IN46176
 Phone: 317-398-8146
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PATRICK A WAGNER PHD PC

NPI Number 1548595440
LBN Legal business name PATRICK A WAGNER PHD PC
Authorized official PATRICK WAGNER - (PSYCHOLOGIST/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/09/2009
Last updated 10/09/2009 - About 17 years ago
Identifiers
IN License # 20010493A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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