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Jackson Wagoner, MD — NPI 1689137408, Casper, WY | NPI Central

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NPI 1689137408

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Jackson Wagoner, MD

NPI 1689137408 · Pain Medicine (Anesthesiology) Physician · Casper, WY

Provider details

NPI number: 1689137408
Entity type: Individual
Primary specialty: Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
Credential: MD
Sex: Male
Sole proprietor: No
License: ME169309 (FL)

Specialties & taxonomies

Pain Medicine (Anesthesiology) PhysicianPrimary207LP2900XLicense 19414A (WY)
Allopathic & Osteopathic Physicians
Pain Medicine (Anesthesiology) Physician207LP2900XLicense ME169309 (FL)
Allopathic & Osteopathic Physicians
Anesthesiology Physician207L00000XLicense 69349 (AZ)
Allopathic & Osteopathic Physicians
Anesthesiology Physician207L00000XLicense ME169309 (FL)
Allopathic & Osteopathic Physicians

Practice location

1541 Diamond Dr

Casper, WY 82601-6247

Phone: (307) 439-1097

Approximate (ZIP-level) locationGet directions

More WY providers

Mailing address

Po Box 100254

Gainesville, FL 32610-0254

Additional practice locations (3)

1501 N Campbell Ave Rm 4401
Tucson, AZ 85724-0001
Phone: (520) 626-7721
1600 Sw Archer Rd
Gainesville, FL 32610-1702
Phone: (352) 273-8610
Fax: (352) 273-8612
2600 Sixth St Sw
Canton, OH 44710-1702
Phone: (330) 452-9911

Registry dates

Enumerated: 2019-04-09
Last updated: 2026-04-08
Certified: 2026-04-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.