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MR. PHILLIP LEROY WAGNER MD NPI 1912931619


NPI Information

NPI: 1912931619
Provider Name: MR. PHILLIP LEROY WAGNER, MD
Classification: Preventive Medicine - 2083X0100X
Entity Type: Individual

Specialization: Occupational Medicine

PECOS Registration: Yes

Address:
975 SERENO DR
OCCUPATIONAL MEDICINE
VALLEJO, CA
ZIP 94589
Phone: (707) 651-2243
Get Directions

MR. Phillip Leroy Wagner, MD is an occupational medicine preventive medicine in Vallejo, CA. The provider is occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. MR. Phillip Leroy Wagner, MD NPI is 1912931619. 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:

975 SERENO DR
OCCUPATIONAL MEDICINE
VALLEJO, CA
ZIP 94589-441
Phone: (707) 651-2243

The NPI 1912931619 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 12/15/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083X0100XPreventive MedicineOccupational Medicine20060083NEW MEXICOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1087585MEDICAIDARIZONA

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: 4/28/2024

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.