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Dr. JACKSON WAGONER MD

Individual Provider (NPI-1) Active

Anesthesiology, Pain Medicine

Provider Information

NPI Number
1689137408
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
1541 DIAMOND DR, CASPER, WY, 826016247
Phone
(307) 439-1097

Specialties & Taxonomies

Anesthesiology, Pain Medicine License: FL #ME169309
Anesthesiology License: AZ #69349
Anesthesiology, Pain Medicine Primary License: WY #19414A
Anesthesiology License: FL #ME169309

All Addresses

LOCATION

1541 DIAMOND DR

CASPER, WY, 826016247

(307) 439-1097

MAILING

PO BOX 100254

GAINESVILLE, FL, 326100254

(352) 273-8610