Individual
DR. DONALD W WAGNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3719 DAUPHIN ST, MOBILE, AL 36608-1753
(251) 471-3921
(251) 476-5460
Mailing address
PO BOX 91628, MOBILE, AL 36691-1628
(251) 471-3921
(251) 476-5460
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
23091
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51060772
BCBS
AL
Enumeration date
12/09/2005
Last updated
06/17/2011
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