Mr. Frederick Joseph Wagner JR.
Optometrist
101 Kimball Rd
Carlisle
, Massachusetts 01741
Mr. Frederick Joseph Wagner JR.
Optometrist
101 Kimball Rd
Carlisle
, Massachusetts 01741
(978) 371-2297
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Mr. Frederick Joseph Wagner JR.
- 101 Kimball Rd
- Carlisle, MA
- Zip : 01741
- Fax : (978) 371-2297
- Phone : (978) 371-2337
Second Address
- Mr. Frederick Joseph Wagner JR.
- 101 Kimball Rd
- Carlisle, MA
- Zip : 01741
- Fax : (978) 371-2297
- Phone : (978) 371-2337
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2408 | MA |
National Provider Identifier
| NPI | 1013052257 |
|---|---|
| Provider Name | Mr. Frederick Joseph Wagner JR. |
| First Address | Carlisle, MA 01741 |
| Second Address | Carlisle, MA 01741 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0320668 | (05) | MA |
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.