DR. Chad Eric Wagoner, MD

NPI #1871582130 in Carthage, Missouri

Provider Information

NPI Number: 1871582130
Entity Type: Individual
Name: DR. Chad Eric Wagoner, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Oct 19, 2005
Last Updated: Nov 15, 2012

Practice Location

Address: 1615 HAZEL ST
City: Carthage
State: Missouri
ZIP Code: 64836-3020
Phone: (417) 359-8803

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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