DR. Brian Leo Waggoner, M.D.

NPI #1679544548 in Clive, Iowa

Provider Information

NPI Number: 1679544548
Entity Type: Individual
Name: DR. Brian Leo Waggoner, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: M.D.
Enumeration Date: Jan 30, 2006
Last Updated: Dec 23, 2016

Practice Location

Address: 2555 BERKSHIRE PKWY STE A
City: Clive
State: Iowa
ZIP Code: 50325-4646
Phone: (515) 987-0051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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