| Jacob Timothy Wagner, DPM | |
|
1836 South Ave, La Crosse, WI 54601-5429 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Jacob Timothy Wagner |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 6 Years |
| Location | 1836 South Ave, La Crosse, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790304442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 1303 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension All Saints Hospital | Racine, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ascension Medical Group-southeast Wisconsin Inc | 8628980943 | 505 |
| Provider Name | Ascension Medical Group-southeast Wisconsin Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
| Provider Name | Gundersen Clinic Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1851343115 PECOS PAC ID: 9638082779 Enrollment ID: O20031106000139 |
| Provider Name | Gundersen Lutheran Medical Center Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1225873458 PECOS PAC ID: 2163331414 Enrollment ID: O20130619000254 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Timothy Wagner, DPM 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Jacob Timothy Wagner, DPM 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 |
Levi Cory Smith, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Fatemeh S Jannati, Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
James B Ringstrom, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
David M Dawson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Hughes Ackom, Podiatrist Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Dr. Scott Collins Carrington, D.P.M Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Bruce B Erdmann, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 |