| Dr Brian Leo Waggoner, MD | |
|
2555 Berkshire Pkwy Ste A, Clive, IA 50325-4646 | |
| (515) 987-0051 | |
| (515) 987-0054 |
| Full Name | Dr Brian Leo Waggoner |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 2555 Berkshire Pkwy Ste A, Clive, Iowa |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679544548 | NPI | - | NPPES |
| 47500 | Other | IA | BCBS |
| 03583 | Other | IA | BCBS |
| 0071670 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 28129 (Iowa) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brian Leo Waggoner, MD 2555 Berkshire Pkwy Ste A, Clive, IA 50325-4646 Ph: (515) 987-0051 | Dr Brian Leo Waggoner, MD 2555 Berkshire Pkwy Ste A, Clive, IA 50325-4646 Ph: (515) 987-0051 |
Jon Vanroekel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Nw 114th St., Suite 345, Clive, IA 50325 Phone: 515-222-7337 Fax: 515-222-7340 | |
Ruby Cureg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Nw 114th St, Suite 345, Clive, IA 50325 Phone: 515-222-7337 | |
Stephanie D O'brien, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Nw 114th St Ste 345, Clive, IA 50325 Phone: 515-222-7337 Fax: 515-222-7340 | |
Sarah Cooper Jackson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1601 Nw 114th St Ste 345, Clive, IA 50325 Phone: 515-222-7337 Fax: 515-222-7340 |