Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wagner Community Memorial Hospital

Organization Family Medicine Physician · NPI 1740306992

Wagner Community Memorial Hospital is a Family Medicine Physician in Wagner, South Dakota. Licensed in South Dakota. Registered with an NPI since 2007.

Licensed in
SD
In the registry since
2007
Specialties on file
3

Practice location Address checks out

513 3rd St SW
Wagner, SD 57380-9675
Phone: (605) 384-3418
Fax: (605) 384-5240
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 10571 (SD)
Physician Assistant Taxonomy 363A00000X · Licence 10571 (SD)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 10571 (SD)

Record details

NPI number1740306992
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bernadette Koupal — Bus. Office Manager · (605) 384-3611
Other names Wagner Community Clinic Avera
NPI enumeratedMarch 21, 2007
Last updated in NPPESMarch 7, 2017
Mailing addressPo Box 280, Wagner, SD 57380-0280

Other providers in Wagner