Provider Type Icon

MR. KARL GORDON WAGNER PA-C NPI 1720179500


NPI Information

NPI: 1720179500
Provider Name: MR. KARL GORDON WAGNER, PA-C
Classification: Physician Assistant - 363A00000X
Entity Type: Individual
Address:
22255 GREENFIELD RD
SUITE 422
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-3195
Get Directions

MR. Karl Gordon Wagner, PA-C is a physician assistant in Southfield, MI. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Karl Gordon Wagner, PA-C NPI is 1720179500. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22255 GREENFIELD RD
SUITE 422
SOUTHFIELD, MI
ZIP 48075-710
Phone: (248) 849-3195
Fax: (248) 849-3390

The enumeration date for this NPI number is 9/27/2006 and was last updated on 12/30/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician Assistant5601001954MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.