Individual
MR. RICHARD ADAM WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5546
(937) 257-0770
Mailing address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5546
(937) 257-0770
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
11/16/2005
Last updated
08/16/2007
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