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DR. BRIAN LEO WAGGONER M.D. NPI 1679544548


NPI Information

NPI: 1679544548
Provider Name: DR. BRIAN LEO WAGGONER, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
2555 BERKSHIRE PKWY STE A
CLIVE, IA
ZIP 50325
Phone: (515) 987-0051
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DR. Brian Leo Waggoner, M.D. is a pediatrics in Clive, IA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Brian Leo Waggoner, M.D. NPI is 1679544548. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2555 BERKSHIRE PKWY STE A
CLIVE, IA
ZIP 50325-646
Phone: (515) 987-0051
Fax: (515) 987-0054

The enumeration date for this NPI number is 1/30/2006 and was last updated on 12/23/2016.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics28129IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
103583OTHERIOWABCBS
247500OTHERIOWABCBS
3FO2139MEDICARE UPINIOWA
40071670MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.