OIG exclusion detail
FREDERICK WAGNER
This page shows an imported LEIE row. Verify details against the official OIG source before acting.
Imported OIG rowOfficial OIG source
- NPI
- 1013052257
- Name
- FREDERICK J JR WAGNER
- Address
- 101 KIMBALL ROAD, APT 79999, CARLISLE, MA, 01741
- Specialty
- OPTOMETRY
- Exclusion type
- 1128a1
- Exclusion date
- 20240718
- Reinstatement date
- 00000000
- Waiver
- 00000000
Source snapshot
Imported: May 05, 2026
Rows: 83,001
Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7
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