MEDICARE: DR. JASON MICHAEL WAGNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	24510	OK

General Provider Information

NPI Number	:	1972594471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON MICHAEL WAGNER MD

Provider Business Mailing Address
First Line	:	940 NE 13TH ST
Second Line	:	SUITE 4G4250
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5008
Country	:	US
Telephone Number	:	405-271-5125
Fax Number	:	405-271-3462

Provider Business Practice Location Address
First Line	:	940 NE 13TH ST
Second Line	:	SUITE 4G4250
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5008
Country	:	US
Telephone Number	:	405-271-5125
Fax Number	:	405-271-3462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	04/24/2010

Similar Medicare Providers

1871749721 — SHADI SALEEM M.D.
Practice Location Address:

940 NE 13TH ST # 4G4250
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-5125
Practice Fax: 405-271-3462

1669460549 — MS. SUSAN J HASSED MS
Practice Location Address:

940 NE 13TH ST , CHO - GENETICS 2B 2418
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-8685
Practice Fax: 405-271-8697

1285616508 — DR. STEVEN RUIZ MD
Practice Location Address:

940 NE 13TH ST # 3G3210
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-5125
Practice Fax: 405-271-3462

1164490777 — AMANDA L BOGIE MD
Practice Location Address:

940 NE 13TH ST , 1B1206
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-4407
Practice Fax:

1881662476 — PRUE ARMSTRONG RCP
Practice Location Address:

940 NE 13TH ST , 3314
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-6390
Practice Fax:

1558339911 — VIRGINIA L GARRISON MD
Practice Location Address:

940 NE 13TH ST , 4G4250
OKLAHOMA CITY, OK
73104-5008

Practice Phone: 405-271-5125
Practice Fax: 405-271-3462

Directions to “ DR. JASON MICHAEL WAGNER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.