Organization
JOHN H WAGNER,III,MD,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN H WAGNER M.D. (PRESIDENT)
(318) 221-8525
Entity
Organization
Contact information
Practice address
1002 HIGHLAND AVE, STE 300, SHREVEPORT, LA 71101-4143
(318) 221-8525
(318) 221-8526
Mailing address
1002 HIGHLAND AVE, STE 300, SHREVEPORT, LA 71101-4143
(318) 221-8525
(318) 221-8526
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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