Richard Wagner , OD,PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

13825 Issued in FL

Legal business name

RICHARD WAGNER , OD,PA

Practice address

218 N Main St
218 N Main St
Chiefland, FL 32626-0802

Phone

(352) 493-4448

Fax

(352) 490-8100

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Richard Wagner, OD

Title

Optometry

Phone

(352) 493-4448

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1598980435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N MAIN ST",
            "address_2": "P.O. BOX 2622",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "326260802",
            "telephone_number": "352-493-4448",
            "fax_number": "352-490-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N MAIN ST",
            "address_2": "218 N MAIN ST",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "326260802",
            "telephone_number": "352-493-4448",
            "fax_number": "352-490-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD WAGNER , OD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OPTOMETRY",
        "authorized_official_telephone_number": "352-493-4448",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "13825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Chiefland, FL
• Providers in Chiefland, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.