Douglas Lee Wagoner, MD

NPI #1225027162 in Glencoe, Minnesota

Provider Information

NPI Number: 1225027162
Entity Type: Individual
Name: Douglas Lee Wagoner, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Oct 13, 2005
Last Updated: Nov 25, 2020

Practice Location

Address: 1805 HENNEPIN AVE N
Address 2: GLENCOE REGIONAL HEALTH SERVICES
City: Glencoe
State: Minnesota
ZIP Code: 55336-1416
Phone: (320) 864-3121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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