Mr Kevin Dale Wagner, MSW - Medicare Clinical Social Worker in Poplar Bluff, MO

Mr Kevin Dale Wagner, MSW is a medicare enrolled "Social Worker - Clinical" provider in Poplar Bluff, Missouri. His current practice location is 1500 N Westwood Blvd, Poplar Bluff, Missouri. You can reach out to his office (for appointments etc.) via phone at (573) 778-4631.

Mr Kevin Dale Wagner is licensed to practice in Missouri (license number SW 04619) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1215139894.

Contact Information

Mr Kevin Dale Wagner, MSW
1500 N Westwood Blvd,
Poplar Bluff, MO 63901-3318
(573) 778-4631
Not Available



Healthcare Provider's Profile

Full NameMr Kevin Dale Wagner
GenderMale
SpecialitySocial Worker - Clinical
Location1500 N Westwood Blvd, Poplar Bluff, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1215139894
  • Provider Enumeration Date: 06/05/2007
  • Last Update Date: 12/26/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 7810178977
  • Enrollment ID: I20140217000347

Medical Identifiers

Medical identifiers for Mr Kevin Dale Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215139894NPI-NPPES
498307107MedicaidMO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical SW 04619 (Missouri)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kevin Dale Wagner is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Kevin Dale Wagner, MSW
1500 N Westwood Blvd,
Poplar Bluff, MO 63901-3318

Ph: (573) 778-4631
Mr Kevin Dale Wagner, MSW
1500 N Westwood Blvd,
Poplar Bluff, MO 63901-3318

Ph: (573) 778-4631

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› Verified 9 days ago


Social Worker in Poplar Bluff, MO

Julie Ross, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901
Phone: 573-686-1200    
Charissa Young, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901
Phone: 573-686-1200    
Janet Sue Mclane-li, LCSW
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-772-7722    Fax: 573-778-7282
Jodi Lynn Jo Walker, LCSW
Clinical Social Worker
Medicare: Medicare Enrolled
Practice Location: 3001 Warrior Ln, Poplar Bluff, MO 63901
Phone: 573-686-1200    
Cynthia J Elliott, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 1910 Greenwood Dr Ste D, Poplar Bluff, MO 63901
Phone: 573-785-5224    
Melinda Gay Taylor, LCSW
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 225 Physicians Park Ste 400, Poplar Bluff, MO 63901
Phone: 573-772-7722    Fax: 573-778-7282
Mrs. Karen Elizabeth Campa, LCSW/MSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 847 Vine St, Poplar Bluff, MO 63901
Phone: 573-778-9424    Fax: 573-778-9447

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