Jerad Wagner, PA-C

NPI 1932448347 · on the registry since 2013

Practice

Address: 921 14th Ave Nw
Ardmore, OK 73401
Phone: (580) 223-5311
Fax: (580) 223-8227
Organisation at this address: Medical Arts Clinic Of Ardmore Inc
Mercy Health Services - Southern Oklahoma, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 7

Registry record

Primary taxonomy: Physician Assistant
363A00000X
Licence states on file: OK
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2016-01-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma