JOHN WAGNER

SHREVEPORT, LA
NPI1033320577
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: LA  MD.201230)
Enumeration Date2007-05-25
Last Update Date2019-05-22
Business Address
-- JOHN WAGNER M.D.
7330 FERN AVE STE 704
SHREVEPORT, LA 71105-4985
Phone number: 318-798-8261
Mailing Address
-- JOHN WAGNER M.D.
7330 FERN AVE STE 704
SHREVEPORT, LA 71105-4985
Phone number: 318-798-8261
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