Daniel Leroy Waggoner
Allergist & Immunologist Allergist
23 Clara Dr Suite 204
Mystic
, Connecticut 06355-1959
Daniel Leroy Waggoner
Allergist & Immunologist Allergist
23 Clara Dr Suite 204
Mystic
, Connecticut 06355-1959
(860) 572-0265
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About
Features
Specialties
- Allergist & Immunologist
- Allergist
Languages spoken
- English
Location
First Address
- Daniel Leroy Waggoner
- 23 Clara Dr Suite 204
- Mystic, CT
- Zip : 06355-1959
- Fax : (860) 572-0265
- Phone : (860) 536-2995
Second Address
- Daniel Leroy Waggoner
- 23 Clara Dr Suite 204
- Mystic, CT
- Zip : 06355-1959
- Fax : (860) 572-0265
- Phone : (860) 536-2995
Reviews
FAQs
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Is Daniel Leroy Waggoner a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 045087 | CT |
| N | 207KA0200X | Allergist | 45087 | CT |
National Provider Identifier
| NPI | 1558406066 |
|---|---|
| Provider Name | Daniel Leroy Waggoner |
| First Address | Mystic, CT 06355-1959 |
| Second Address | Mystic, CT 06355-1959 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2007 |
| Last Update Date | 25/03/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H76865 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.