Wagner & Wagner PSC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WAGNER & WAGNER PSC

Doing business as

Wagner Eye Care Center

Practice address

115 Columbia Ave
Glasgow, KY 42141-2903

Phone

(270) 651-8323

Fax

(270) 651-8324

NPI assigned

Dec 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ronald T. Wagner, O. D.

Title

President

Phone

(270) 651-8323

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wagner Eye Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1124180351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421420638",
            "telephone_number": "270-651-8323",
            "fax_number": "270-651-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COLUMBIA AVE",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421412903",
            "telephone_number": "270-651-8323",
            "fax_number": "270-651-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER & WAGNER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-651-8323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77900561",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagner Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Paul Vaughn, PT
• Jose Orlando Vazquez-Vicente, D.O.
• Eric Todd Vessels, M.D.
• Michele Grace Vincent, APRN
• W. Craig Tyree, MD, PLC
• Ronald T. Wagner, O. D.
• Derrick Wagoner, LPCC
• Irfan Waheed, M.D.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0711)
• Wal-Mart Stores East, LP (Vision Center 30-0711)

• Optometrist in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.