Wagnon, Jason

Wagnon, Jason is an individual health care provider with primary practice located at 5500 Central Ave Ste A , Hot Springs AR 71913-9712. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Wagnon, Jason can be contacted via phone (501) 701-4339.

Contact Information

Primary practice address
5500 Central Ave Ste A Hot Springs AR 71913-9712
Phone: (501) 701-4339
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X PT2449 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2449 Arkansas

Profile Details

NPI number 1639285265
LBN Legal business name Wagnon, Jason
Credentials PT, DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Jul 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639285265 NPPES
Arkansas MEDICAID 141072721

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