IndividualActive
John Wagner, M.D.
NPI 1033320577 · Child & Adolescent Psychiatry Physician · Shreveport, LA
Provider details
- NPI number
- 1033320577
- Entity type
- Individual
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- MD.201230 (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7330 Fern Ave Ste 704
Shreveport, LA 71105-4985
Phone: (318) 798-8261
Fax: (316) 798-8263
Approximate (ZIP-level) locationGet directions
Mailing address
7330 Fern Ave Ste 704
Shreveport, LA 71105-4985
Registry dates
- Enumerated
- 2007-05-25
- Last updated
- 2019-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.