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1003532268
CHARLES WESLEY WAGNER
LITTLE ROCK, AR
NPI
1003532268
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2086S0120X Surgery, Pediatric Surgery
(Licence: AR N-7036)
Enumeration Date
2022-10-18
Last Update Date
2022-10-18
Business Address
CHARLES WESLEY WAGNER MD
12609 SAINT CHARLES BLVD
LITTLE ROCK, AR 72211-2227
Phone number: 501-680-0738
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Mailing Address
CHARLES WESLEY WAGNER MD
1 CHILDRENS WAY
LITTLE ROCK, AR 72202-3500
Phone number: 501-364-1447
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