Dr. Brian Keith Wagner
Podiatrist Radiology Foot Surgery Foot & Ankle Surgery
11 South Rd Lowr Level20
Farmington
, Connecticut 06032-2483
Dr. Brian Keith Wagner
Podiatrist Radiology Foot Surgery Foot & Ankle Surgery
11 South Rd Lowr Level20
Farmington
, Connecticut 06032-2483
(860) 606-8025
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About
Features
Specialties
- Podiatrist
- Radiology
- Foot & Ankle Surgery
- Foot Surgery
Languages spoken
- English
Location
First Address
- Dr. Brian Keith Wagner
- 11 South Road Lower Level 20
- Farmington, CT
- Zip : 06032
- Fax : (860) 606-8025
- Phone : (860) 470-5703
Second Address
- Dr. Brian Keith Wagner
- 11 South Rd Lowr Level20
- Farmington, CT
- Zip : 06032-2483
- Fax : (860) 606-8025
- Phone : (860) 470-5703
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 000793 | CT |
| N | 222Z00000X | Podiatrist | 000793 | CT |
| N | 111NR0200X | Radiology | 000793 | CT |
| N | 213ER0200X | Radiology | 000793 | CT |
| N | 213ES0103X | Foot & Ankle Surgery | 000862 | CT |
| Y | 213ES0131X | Foot Surgery | 000793 | CT |
National Provider Identifier
| NPI | 1093743502 |
|---|---|
| Provider Name | Dr. Brian Keith Wagner |
| First Address | Farmington, CT 06032 |
| Second Address | Farmington, CT 06032-2483 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2006 |
| Last Update Date | 20/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| V00867 | (02) | CT |
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.