Dr. Brian Leo Waggoner
M.D. | Pediatrics | Male
Dr. Brian Leo Waggoner, M.D. is a Clive, Iowa based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Brian Leo Waggoner is
2555 Berkshire Pkwy Ste A, Clive, Iowa - 50325-4646. He can be contacted on phone at
515-987-0051 and fax number 515-987-0054.
Dr. Brian Leo Waggoner is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Brian Leo Waggoner is
1679544548 which was assigned by NPPES on 30 Jan, 2006 and it was last updated on 23 Dec, 2016.
Dr. Brian Leo Waggoner license number is
28129 for Pediatrics (208000000X) in Iowa.
Dr. Brian Leo Waggoner is a pediatrician who 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.
Complete Profile:
Dr. Brian Leo Waggoner basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Dr. Brian Leo Waggoner |
|---|
| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dr. Brian Leo Waggoner address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2555 Berkshire Pkwy Ste A
Clive, IA, 50325-4646
United States |
|---|
| Phone Number : | 515-987-0051 |
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| Fax Number : | 515-987-0054 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1679544548 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 30 Jan, 2006 |
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| Last Updated On : | 23 Dec, 2016 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Brian Leo Waggoner are as mentioned. Primary taxonomy code for Dr. Brian Leo Waggoner, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 28129 | IA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Brian Leo Waggoner such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 03583 | Other | IA | BCBS |
| 47500 | Other | IA | BCBS |
| 0071670 | MEDICAID | IA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2555 Berkshire Pkwy Ste A
Clive, IA, 50325-4646
United States |
|---|
| Phone Number : | 515-987-0051 |
|---|
| Fax Number : | 515-987-0054 |
|---|
Business Location:
Patients can refer following map for directions to
Dr. Brian Leo Waggoner practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.