IndividualActive
John Waggoner, PSY.D.
NPI 1710040886 · Psychologist · Keesler Afb, MS
Provider details
- NPI number
- 1710040886
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 601056 (MS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
301 Fisher St
Keesler Afb, MS 39534-2508
Phone: (228) 376-0385
Approximate (ZIP-level) locationGet directions
Mailing address
301 Fisher St
Keesler Afb, MS 39534-2508
Registry dates
- Enumerated
- 2006-12-19
- Last updated
- 2022-05-24
- Certified
- 2022-05-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.