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1336180900
DIANE BROWN WAGNER
SHREVEPORT, LA
NPI
1336180900
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: LA MD019017)
Enumeration Date
2006-06-08
Last Update Date
2014-02-02
Business Address
-- DIANE BROWN WAGNER MD
1453 E BERT KOUNS LOOP RADIOLOGY
SHREVEPORT, LA 71105-6800
Phone number: 318-681-5440
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Mailing Address
-- DIANE BROWN WAGNER MD
PO BOX 9600 DEPT 09-038
TEXARKANA, TX 75505-9600
Phone number: 918-622-0436
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