| Dr Traci Lee Wagner, MD | |
|
580 St. Johnsbury Rd., Littleton, NH 03561 | |
| (603) 444-7070 | |
| (603) 788-5027 |
| Full Name | Dr Traci Lee Wagner |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 580 St. Johnsbury Rd., Littleton, New Hampshire |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932187465 | NPI | - | NPPES |
| 30205431 | Medicaid | NH | |
| 1011825 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 12859 (New Hampshire) | Primary |
| Entity Name | Littleton Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144223702 PECOS PAC ID: 6901796556 Enrollment ID: O20040322000785 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Traci Lee Wagner, MD 133 Pleasant St, Berlin, NH 03570-2006 Ph: (603) 752-2040 | Dr Traci Lee Wagner, MD 580 St. Johnsbury Rd., Littleton, NH 03561 Ph: (603) 444-7070 |
Jessica Payne Jacobs, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 580 St. Johnsbury Rd., Littleton, NH 03561 Phone: 603-444-7070 Fax: 203-438-6456 | |
Dr. Sarah Reynolds, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 600 Saint Johnsbury Rd, 580 Saint Johnsbury Rd, Littleton, NH 03561 Phone: 603-444-7070 Fax: 603-575-6288 | |
Sunit H. Patel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 580 St. Johnsbury Rd., Littleton, NH 03561 Phone: 603-444-7070 Fax: 603-575-6288 | |
William Lakey, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 580 Saint Johnsbury Rd, North Country Pediatrics, Littleton, NH 03561 Phone: 603-444-2803 Fax: 603-444-4073 |