DR. BRIAN KEITH WAGNER (NPI# 1093743502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093743502 |
| Entity Type | Individual |
| Full Name | DR. BRIAN KEITH WAGNER |
| Credential | D.P.M. |
| Practice Address |
11 South Rd Lowr Level20 Farmington CT 06032-2483 |
| Mailing Address |
11 South Road Lower Level 20 Farmington CT 06032 |
| Practice Telephone | 8604705703 |
| Practice Fax Number | 8606068025 |
| Mailing Telephone | 8604705703 |
| Mailing Fax Number | 8606068025 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 000793 | CT | Podiatric Medicine & Surgery Service Providers |
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
000793 | CT | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
000862 | CT | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
000793 | CT | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 133 Hartford Ave, East Granby, CT 060269519 | 8606534708 | 8606068025 |
| 43 Woodland St, Suite 210, Hartford, CT 061052363 | 8602517200 | 8602517231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811177751 | Brian Edwin Wagner | Pharmacist | 1616 Black River Blvd N, Rome, NY 13440-3609 | 2007-11-08 |
| 1477633931 | Brian J Wagner | Obstetrics & Gynecology | 1176 Fifith Avenue E Level, New York, NY 10029-6501 | 2006-10-17 |
| 1790893410 | Brian M Wagner | Dentist | 7120 S Us Highway 231, Huntingburg, IN 47542-9319 | 2006-08-25 |
| 1114333549 | Brian Wagner | Counselor | 250 Dewey Ave, Spartanburg, SC 29303-3009 | 2014-07-07 |
| 1265576433 | Brian Wagner | Marriage & Family Therapist | 1885 Lundy Ave, Suite 223, San Jose, CA 95131-1887 | 2007-02-19 |
| 1831204270 | Brian R. Wagner | Counselor | 73 S Central Ave, Valley Stream, NY 11580-5402 | 2006-08-19 |
| 1205815917 | Brian Lee Wagner | Anesthesiology | 3315 Watt Ave, Sacramento, CA 95821-3600 | 2006-01-11 |
| Street Address |
11 SOUTH RD LOWR LEVEL20 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06032-2483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487684346 | Connecticut Foot Specialists, P.C. | Durable Medical Equipment & Medical Supplies | 11 South Rd Lowr Level20, Farmington, CT 06032-2483 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499435 | Kelsey Erin Boyne | Student in an Organized Health Care Education/Training Program | 200 Academic Way, Farmington, CT 06032 | 2020-02-19 |
| 1760024723 | Baliram Maraj | Dentist | 801 Plainville Ave., Farmington, CT 06032 | 2019-10-11 |
| 1770144958 | Dominique Feterman Jimenez | Student in an Organized Health Care Education/Training Program | Internal Medicine Associates Outpatient Pavilion 2 West, 263 Farmington Avenue, Farmington, CT 06032 | 2019-06-27 |
| 1033770698 | Tiffany Otto | Nurse Practitioner | 27o Farmington Avenue, # 309, Farmington, CT 06032 | 2019-06-25 |
| 1124683941 | Aleksandra M Sliwinska | Student in an Organized Health Care Education/Training Program | Uconn Health Im Associates, 263 Farmington Avenue, Op, 2 West, Farmington, CT 06032 | 2019-05-07 |
| 1922663889 | Sean Ag Harford | Student in an Organized Health Care Education/Training Program | Uconn Health - Internal Medicine Associates, 263 Farmington Avenue, Op, 2 West, Farmington, CT 06032 | 2019-05-07 |
| 1710450507 | Kathy Jean Campbell | Occupational Therapist | 10 Birdseye Rd, Farmington, CT 06032 | 2019-01-04 |
| 1790273373 | Cameron Seymour | Dentist | 291 Farmington Ave Ste 5, Farmington, CT 06032 | 2018-04-29 |
| 1881181790 | Robin L Shahverdian LLC | Counselor | 304 Main St Ste D428, Farmington, CT 06032 | 2018-04-16 |
| 1588160998 | Sight Sensory Rehabilitation Center, Pllc | Optometrist | 10 Birdseye Road, Farmington, CT 06032 | 2018-04-04 |
| Find all providers in zip 06032 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215011218 | Bryan Kent Broadbent | Podiatrist | 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991 | 2006-10-25 |
| 1093928673 | Samuel C. Carpenter, Dpmpc | Podiatrist | 4801 N Butler Ave, Suite 9102, Farmington, NM 87401-6002 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306199351 | Starling Physicians PC | Podiatrist | 160 Hazard Ave, Enfield, CT 06082-3889 | 2012-10-15 |
| 1073887923 | Bruce M Backer | Podiatrist | 272 Charles Ct, Orange, CT 06477-1629 | 2012-02-23 |
| 1275617102 | Podiatric Medicine and Surgery of Fairfield County | Podiatrist | 49 Londonderry Dr, Greenwich, CT 06830-3508 | 2006-10-25 |
| 1679655443 | Central Connecticut Footcare Center, LLC | Podiatrist | 807 Broad St., Meriden, CT 06450-3802 | 2006-10-20 |
| 1689782401 | Chris Paul Kassaris | Podiatrist | 1881 Post Rd, Fairfield, CT 06824-5721 | 2006-08-29 |
| 1184632028 | Peter T Labarbera | Podiatrist | 389 Highland Ave, Waterbury, CT 06708 | 2006-08-04 |
| 1487684288 | Harvey D. Lederman | Podiatrist | 2531 Albany Ave, West Hartford, CT 06117-2308 | 2006-07-04 |
| 1588694764 | Luca Di Matteo | Podiatrist | 538 Hopmeadow St, Simsbury, CT 06070-2415 | 2006-07-04 |
| 1669421665 | Anthony Babigian | Podiatrist | 520 West Ave, Norwalk, CT 06850-4034 | 2006-05-08 |
| 1568427607 | Benedict Charles Valentine II | Podiatrist | 8 Independence Dr, Marlborough, CT 06447-1408 | 2006-04-20 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 06032 |
Please comment or provide details below to improve the information on DR. BRIAN KEITH WAGNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.