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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DYLAN PAUL WAGNER, PA

Active

DYLAN PAUL WAGNER, PA is a Medical Physician Assistant healthcare provider located in LAUREL, Mississippi. NPI 1992058556 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · LAUREL, MS

Registration Details

NPI Number
1992058556
Provider Type
Individual
Gender
Male
NPI Issued
Oct 19, 2012 (13.781012722667 yrs)
Last Updated
Jul 23, 2020
License
00172 (MS)

Practice Information

Address
2313 HIGHWAY 15 N
LAUREL, MS, 394401805
Browse MS providers · Browse ZIP 39440
Phone
6016492775
Fax
6016492686
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in LAUREL, MS

Name Credential NPI
MR. ALAN BRYSON PA 1740675487
MRS. TIFFANY EDWARDS KEITH MHS, PA-C 1720441355
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.