Individual provider · Type 1 NPI

Dustin Wagner, PA

Surgical Physician Assistant · Oklahoma City, OK

NPI number 1093453565 Active

Practice location

5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090

Call (405) 713-9940 Map

Fax (405) 713-9941

Mailing address

3001 Quail Springs Pkwy Fl 5
Oklahoma City, OK 73134-2640

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X4800 (OK)

Surgical Physician Assistant: Definition to come...

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About NPI 1093453565

Dustin Wagner, PA's National Provider Identifier is 1093453565, issued on May 24, 2022. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Oklahoma City, OK. The record was last updated on Jan 12, 2023.