Jerad Scott Wagner, PA-C

Physician Assistant · Ardmore, OK

Individual Active NPI

NPI number 1932448347

Practice location

921 14TH Ave NW
Ardmore, OK 73401-1837
Phone
(580) 223-5311
Fax
(580) 223-8227

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NPI record

NPI
1932448347
Entity type
Individual (Type 1)
Enumeration date
February 5, 2013
Last updated
January 27, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 2197 OK

About Jerad Wagner

Jerad Scott Wagner, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 921 14TH Ave NW, Ardmore, OK 73401-1837. The NPI number 1932448347 was assigned on February 5, 2013 and the record was last updated on January 27, 2016.

Jerad Wagner lists a license in the registry: #2197 (OK) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jerad Scott Wagner, PA-C?

The NPI number is 1932448347.

What is the phone number of Jerad Wagner?

The phone number listed for the practice location is (580) 223-5311.

Where is Jerad Wagner located?

921 14TH Ave NW, Ardmore, OK 73401-1837.

What is the taxonomy code for Jerad Wagner?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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