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Kendall D. Wagner, M.d., Pllc
Primary Care Clinic/Center in Fort Smith, Arkansas
NPI 1528721271

Kendall D. Wagner, M.d., Pllc is a Primary Care Clinic/Center based in Fort Smith, AR and is specialized in Primary Care. Kendall D. Wagner, M.d., Pllc practices in Fort Smith, AR. The NPI Number for Kendall D. Wagner, M.d., Pllc is 1528721271 and holds a License No. (Arkansas).

The current practice location address for Kendall D. Wagner, M.d., Pllc is 11300 Roberts Blvd, Fort Smith, AR and can be reached out via phone at 000-000-0000.

Location: 11300 Roberts Blvd, Fort Smith, AR, 72916-9787
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528721271
Provider Name
Kendall D. Wagner, M.d., Pllc
Credential
Provider Entity Type
Organization
Address
11300 Roberts Blvd, Fort Smith, AR, 72916-9787
Phone Number
000-000-0000
Fax Number
Provider Enumeration Date
10/20/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
202855001 05 AR
institution
Provider Business Practice Location Address Details
Address
11300 Roberts Blvd
City
Fort Smith
State
Arkansas
Zip
72916-6027
Phone Number
000-000-0000
Fax Number
person
Provider Business Mailing Address Details
Address
11300 Roberts Blvd
City
Fort Smith
State
Arkansas
Zip
72916-6027
Phone Number
000-000-0000
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
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Definition
Definition to come...
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