MEDICARE: MADISON WAGNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	009530	AZ

General Provider Information

NPI Number	:	1194673947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON WAGNER DC

Provider Business Mailing Address
First Line	:	8700 E VISTA BONITA DR STE 188
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-3205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 E VISTA BONITA DR STE 188
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-3205
Country	:	US
Telephone Number	:	602-847-0921
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ MADISON WAGNER DC” Practice Location

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