NPIMap

Organization Active NPI

Mitchell S Wagner MD PLLC

  • Orthopaedic Surgery Physician
  • Tempe, AZ
National Provider Identifier
1326338989
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
27272 Issued in AZ
Legal business name
MITCHELL S WAGNER MD PLLC
Practice address
60 E Rio Salado Pkwy
Ste 505
Tempe, AZ 85281-9128
Phone
(602) 903-0443
Fax
(480) 777-1345
NPI assigned
Apr 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Dr. Mitchell S Wagner, M.D.
Title
President
Phone
(602) 903-0443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 27272 AZ Primary

Addresses

Primary practice location

60 E Rio Salado Pkwy
Ste 505
Tempe, AZ 85281-9128

Mailing address

60 E Rio Salado Pkwy
Ste 505
Tempe, AZ 85281-9128
Phone (602) 903-0443

National Provider Directory

National Provider Directory

Locations

60 E Rio Salado Pkwy
Ste 505
Tempe, AZ 85281
Phone (480) 449-3979

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1326338989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E RIO SALADO PKWY",
            "address_2": "STE 505",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852819128",
            "telephone_number": "602-903-0443",
            "fax_number": "480-777-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E RIO SALADO PKWY",
            "address_2": "STE 505",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852819128",
            "telephone_number": "602-903-0443",
            "fax_number": "480-777-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL S WAGNER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-903-0443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "27272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.