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1972594471
JASON MICHAEL WAGNER
OKLAHOMA CITY, OK
NPI
1972594471
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: OK 24510)
Enumeration Date
2005-11-03
Last Update Date
2010-04-24
Business Address
Dr. JASON MICHAEL WAGNER MD
940 NE 13TH ST SUITE 4G4250
OKLAHOMA CITY, OK 73104-5008
Phone number: 405-271-5125
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Mailing Address
Dr. JASON MICHAEL WAGNER MD
940 NE 13TH ST SUITE 4G4250
OKLAHOMA CITY, OK 73104-5008
Phone number: 405-271-5125
Copy
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