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MR. KARL GORDON WAGNER JR. PA-C
NPI 1720179500
Physician Assistant in Southfield, MI

Active since September 27, 2006
22255 GREENFIELD RD, SUITE 422, SOUTHFIELD, MI 48075(248) 849-3195(248) 849-3390 Get Directions Write a Review

NPPES record last updated: December 30, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mr. Karl Gordon Wagner Jr. Pa-c NPPES

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

MR. KARL GORDON WAGNER JR. PA-C (NPI 1720179500) is an individual physician assistant in Southfield, Michigan, licensed in Michigan (5601001954) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1720179500
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KARL GORDON WAGNER JR.Credential: PA-C
Location Address22255 GREENFIELD RD, SUITE 422Southfield, MI 48075-3710
Mailing Address57813 Cider Mill DrNew Hudson, MI 48165-9482 · (248) 486-4364
Phone(248) 849-3195
Fax(248) 849-3390
Sole ProprietorNo
Enumeration DateSeptember 27, 2006
Last NPPES UpdateDecember 30, 2009
✔ NPI 1720179500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601001954
Definition
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.
22255 GREENFIELD RD, Southfield, MI 48075
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Other Providers at the Same Location NPPES 20

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

BEVERLY CAMERON RD, CDE
Dietitian, Registered
22255 GREENFIELD RD, SUITE 400
SOUTHFIELD, MI 48075
Oakland County (248) 849-3381
BETHANY RALPH DPT
Physical Therapist
22255 GREENFIELD RD
SOUTHFIELD, MI 48075
Oakland County (248) 849-3907
JENNIFER PORCO NP
Nurse Practitioner (Occupational Health)
22255 GREENFIELD RD
SOUTHFIELD, MI 48075
Oakland County (248) 849-3195
WENDY MARIE YODER MA, LPC
Counselor
22255 GREENFIELD RD, #132
SOUTHFIELD, MI 48075
Oakland County (248) 849-3301
LISA HILTON LMSW
Social Worker (Clinical)
22255 GREENFIELD RD, SUITE 300
SOUTHFIELD, MI 48075
Oakland County (248) 849-3301
SHELLEY ADAMS PT
Physical Therapist
22255 GREENFIELD RD
SOUTHFIELD, MI 48075
Oakland County (248) 849-3907
LESTER EDWARD POTEMPA DO
Psychiatry & Neurology (Psychiatry)
22255 GREENFIELD RD, 132
SOUTHFIELD, MI 48075
Oakland County (248) 849-3301
DAYNA MICHELLE MULLALY L.M.S.W.
Social Worker (Clinical)
22255 GREENFIELD RD, SUITE 300
SOUTHFIELD, MI 48075
Oakland County (248) 849-3301

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 Karl Wagner's NPI number?

The NPI number for Karl Wagner is 1720179500. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Where is Karl Wagner located?

Karl Wagner practices at 22255 Greenfield Rd Suite 422, Southfield, MI 48075. The listed phone number is (248) 849-3195.

What is Karl Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Karl Wagner was last updated on December 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.