KENDALL D. WAGNER M.D. PLLC NPI 1528721271

NPI Information

KENDALL D. WAGNER, M.D., PLLC is a primary care clinic center in Fort Smith, AR. KENDALL D. WAGNER, M.D., PLLC NPI is 1528721271. The provider is registered as an organization entity type.

The provider's business location address is:

11300 ROBERTS BLVD
FORT SMITH, AR
ZIP 72916-027
Phone: (000) 000-0000

The provider's authorized official is Kendall Darren Wagner .
The authorized official title is Physician and has the following contact phone number (501) 766-6311.

The enumeration date for this NPI number is 10/20/2021 and was last updated on 10/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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