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Individual

DR. AUSTIN J WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3600 NE RALPH POWELL RD STE D, LEES SUMMIT, MO 64064-2369
(816) 675-0920
Mailing address
3600 NE RALPH POWELL RD STE D, LEES SUMMIT, MO 64064-2369
(816) 675-0920

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
05-41644
KS
2086S0129X
Vascular Surgery Physician
Primary
2015007378
MO

Other

Enumeration date
07/28/2008
Last updated
09/23/2025
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