Meredith Wall Wagner
Plastic and Reconstructive Surgery
6254 Poplar Ave
Memphis
, Tennessee 38119
Meredith Wall Wagner
Plastic and Reconstructive Surgery
6254 Poplar Ave
Memphis
, Tennessee 38119
(901) 624-3333
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Meredith Wall Wagner
- 6254 Poplar Ave
- Memphis, TN
- Zip : 38119-4713
- Phone : (901) 624-3333
Second Address
- Meredith Wall Wagner
- 6254 Poplar Ave
- Memphis, TN
- Zip : 38119
- Phone : (901) 624-3333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | 58455 | TN |
National Provider Identifier
| NPI | 1316380694 |
|---|---|
| Provider Name | Meredith Wall Wagner |
| First Address | Memphis, TN 38119-4713 |
| Second Address | Memphis, TN 38119 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/04/2013 |
| Last Update Date | 24/05/2019 |
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.