Individual provider · Type 1 NPI

Dylan Paul Wagner, PA

Medical Physician Assistant · Laurel, MS

NPI number 1992058556 Active

Practice location

2313 Highway 15 N
Laurel, MS 39440-1805

Call (601) 649-2775 Map

Fax (601) 649-2686

Mailing address

415 S 28th Ave
Hattiesburg, MS 39401-7246

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X00172 (MS)

Medical Physician Assistant: Definition to come...

5 other providers at this address

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About NPI 1992058556

Dylan Paul Wagner, PA's National Provider Identifier is 1992058556, issued on Oct 19, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Laurel, MS. The record was last updated on Jul 23, 2020.