CHARLES WESLEY WAGNER MD NPI 1003532268

NPI Information

  • NPI: 1003532268
  • Provider Name: CHARLES WESLEY WAGNER, MD
  • Classification: Surgery - 2086S0120X
  • Specialization: Pediatric Surgery
  • Entity Type: Individual
  • Address: 12609 SAINT CHARLES BLVD
    LITTLE ROCK, AR
    ZIP 72211
  • Phone: (501) 680-0738

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NPI Details

Charles Wesley Wagner, MD is a pediatric surgery surgery in Little Rock, AR. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Charles Wesley Wagner, MD NPI is 1003532268. 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:

12609 SAINT CHARLES BLVD
LITTLE ROCK, AR
ZIP 72211-227
Phone: (501) 680-0738

The enumeration date for this NPI number is 10/18/2022 and was last updated on 10/18/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0120XSurgeryPediatric SurgeryN-7036ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1N-7036OTHERARKANSASGENERAL PRACTICE
2N-7036MEDICAIDARKANSAS

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: 11/21/2025

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