Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CASEY WAGNER, M.D.
ActiveDR. CASEY WAGNER, M.D. is a Sports Medicine healthcare provider located in JONESBORO, Georgia. NPI 1306108279 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · JONESBORO, GA
Registration Details
- NPI Number
- 1306108279
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2012 (14.205725035835 yrs)
- Last Updated
- Aug 12, 2019
- Licenses
-
82480 (GA)E9863 (AR)
Practice Information
- Address
-
7813 SPIVEY STATION BLVD STE 220JONESBORO, GA, 30236Browse GA providers · Browse ZIP 30236
- Phone
- 4047783350
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.