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Individual
DR. JAMEY PAUL WAGNER
Active
Individual
DR. JAMEY PAUL WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
1765
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51046363
BLUE CROSS BLUE SHIELD
AL
01
—
5192287
AETNA
AL
01
—
641153
ACN
AL
Enumeration date
01/28/2007
Last updated
07/09/2007
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