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Theodore T Wagner III, MD
Urology Physician in Fort Wayne, Indiana
NPI 1831162791

Theodore T Wagner III is a Urology Physician based in Fort Wayne, IN. Theodore T Wagner III practices in Fort Wayne, IN and has the professional credentials of MD. The NPI Number for Theodore T Wagner III is 1831162791 and holds a License No. 01050471A (Indiana).

The current practice location address for Theodore T Wagner III is 11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN and can be reached out via phone at 260-425-5400 and via fax at 260-425-5417. You can also correspond with Theodore T Wagner III through the mailing address at 11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN - 46845-1701 (mailing address contact number: ).

Location: 11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN, 46845-1701
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Provider Profile Details
NPI Number
1831162791
Provider Name
Theodore T Wagner III
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11141 Parkview Plaza Dr Ste 325, Fort Wayne, IN, 46845-1701
Phone Number
260-425-5400
Fax Number
260-425-5417
Provider Enumeration Date
02/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100081380 05 IN
0748972 05 OH
000000087512 01 IN ANTHEM BC/BS
200245650 05 IN
2568556 05 OH
institution
Provider Business Practice Location Address Details
Address
11141 Parkview Plaza Dr Ste 325
City
State
Zip
46845-1714
Phone Number
260-425-5400
Fax Number
260-425-5417
person
Provider Business Mailing Address Details
Address
11109 Parkview Plaza Dr # 117
City
State
Zip
46845-1701
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
License No.
01050471A (Indiana)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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