| Doctor Name: | LENARD D WAGNER |
| NPI Number: | 1649216896 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | CS00009180 |
| Business Practice Address: | 1600 North Main Lovington, NM - 882602813 |
| Business Phone Number: | 5753966611 |
| Business Fax Number: | 5753960318 |
| Mailing Address: | 200 W Lea St, HOBBS |
| State: | NM |
| Postal Code: | 882405110 |
| Phone Number: | 5753910270 |
| Fax Number: | 5753910271 |
| NPI Enumeration Date: | 06/22/2006 |
| NPI Last Update Date: | 01/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | CS00009180 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |