BENJAMIN J WAGNER

CARBONDALE, IL
NPI1497047567
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036140784)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: PA  OS016686)
Enumeration Date2011-05-09
Last Update Date2021-02-11
Business Address
Dr. BENJAMIN J WAGNER DO
405 W JACKSON ST
CARBONDALE, IL 62901-1462
Phone number: 618-549-0721
Mailing Address
Dr. BENJAMIN J WAGNER DO
1086 FRANKLIN ST
JOHNSTOWN, PA 15905-4305
Phone number: 814-534-3745