JACK C WAGNER
NPI 1093510810
Student in an Organized Health Care Education/Training Program in Oklahoma City, OK

Q: What is Jack Wagner's NPI number?

The NPI number for Jack Wagner is 1093510810. It was assigned to this individual provider in the NPPES registry on February 17, 2025.

Q: What is Jack Wagner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Wagner was last updated on February 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 17, 2025

2200 N CLASSEN BLVD, OKLAHOMA CITY, OK 73106(405) 760-2673 Get Directions Write a Review

NPPES record last updated: February 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jack C Wagner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK C WAGNER (NPI 1093510810) is an individual student in an organized health care education/training program in Oklahoma City, Oklahoma and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1093510810

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK C WAGNER

Location Address2200 N CLASSEN BLVDOklahoma City, OK 73106-5800

Mailing Address800 Stanton L Young BlvdOklahoma City, OK 73104-5018 · (405) 271-2316

Phone(405) 760-2673

Sole ProprietorNo

Enumeration DateFebruary 17, 2025

NPPES CertifiedFebruary 16, 2025

✔ NPI 1093510810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2200 N CLASSEN BLVD, Oklahoma City, OK 73106

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEROME ANTHONY MCTAGUE MD, JD

Emergency Medicine

2200 N CLASSEN BLVD, SUITE 1403
OKLAHOMA CITY, OK 73106

Oklahoma County (419) 461-1057

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Wagner's NPI number?

The NPI number for Jack Wagner is 1093510810. It was assigned to this individual provider in the NPPES registry on February 17, 2025.

Where is Jack Wagner located?

Jack Wagner practices at 2200 N Classen Blvd, Oklahoma City, OK 73106. The listed phone number is (405) 760-2673.

What is Jack Wagner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jack Wagner was last updated on February 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.