Dr. Casey Wagner
Family Doctor - Sports Medicine
7813 Spivey Station Blvd Ste 220
Jonesboro
, Georgia 30236
Dr. Casey Wagner
Family Doctor - Sports Medicine
7813 Spivey Station Blvd Ste 220
Jonesboro
, Georgia 30236
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Casey Wagner
- 7813 Spivey Station Blvd Ste 220
- Jonesboro, GA
- Zip : 30236-2900
- Phone :
Second Address
- Dr. Casey Wagner
- 7813 Spivey Station Blvd Ste 220
- Jonesboro, GA
- Zip : 30236
- Phone : (404) 778-3350
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207QS0010X | Family Doctor - Sports Medicine | 82480 | GA |
| Y | 207QS0010X | Family Doctor - Sports Medicine | E9863 | AR |
National Provider Identifier
| NPI | 1306108279 |
|---|---|
| Provider Name | Dr. Casey Wagner |
| First Address | Jonesboro, GA 30236-2900 |
| Second Address | Jonesboro, GA 30236 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/06/2012 |
| Last Update Date | 12/08/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.