Individual
BRIAN WILLIAM WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(888) 397-8387
Mailing address
3374 E 550, LOCUST GROVE, OK 74352-7848
(918) 232-2980
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
206468
OK
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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