Individual provider · Type 1 NPI

Jack C. Wagner

Student in an Organized Health Care Education/Training Program · Oklahoma City, OK

NPI number 1093510810 Active

Practice location

2200 N Classen Blvd
Oklahoma City, OK 73106-5800

Call (405) 760-2673 Map

Mailing address

800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1093510810

Jack C. Wagner's National Provider Identifier is 1093510810, issued on Feb 17, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Oklahoma City, OK. The record was last updated on Feb 17, 2025.