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1477187383
ROY MARSHALL WAGNER
O FALLON, IL
NPI
1477187383
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036164627)
Enumeration Date
2020-02-29
Last Update Date
2023-11-07
Business Address
Dr. ROY MARSHALL WAGNER DO
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269
Phone number: 618-233-7880
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Mailing Address
Dr. ROY MARSHALL WAGNER DO
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL 62269-1284
Phone number: 618-256-9355
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