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Dylan Wagner, PA
NPI 1992058556 · on the registry since 2012
Practice
- Address
- 2313 Highway 15 N
Laurel, MS 39440 - Phone
- (601) 649-2775
- Fax
- (601) 649-2686
- Organisation at this address
- Hattiesburg Clinic Pa
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 363AM0700X
363AM0700X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-07-23
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 Mississippi