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Individual

WILLIAM WAGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554-1436
(304) 366-0700
Mailing address
107 COWELL ST, WESTOVER, WV 26501-3809

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
124345
WV

Other

Enumeration date
10/20/2025
Last updated
10/20/2025
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