person
Charles Wesley Wagner, MD
Pediatric Surgery Physician in Little Rock, Arkansas
NPI 1003532268

Charles Wesley Wagner is a Pediatric Surgery Physician based in Little Rock, AR and is specialized in Pediatric Surgery. Charles Wesley Wagner practices in Little Rock, AR and has the professional credentials of MD. The NPI Number for Charles Wesley Wagner is 1003532268 and holds a License No. N-7036 (Arkansas).

The current practice location address for Charles Wesley Wagner is 12609 Saint Charles Blvd, Little Rock, AR and can be reached out via phone at 501-680-0738.

Location: 12609 Saint Charles Blvd, Little Rock, AR, 72202-3500
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Provider Profile Details
NPI Number
1003532268
Provider Name
Charles Wesley Wagner
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
12609 Saint Charles Blvd, Little Rock, AR, 72202-3500
Phone Number
501-680-0738
Fax Number
Provider Enumeration Date
10/18/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
N-7036 01 AR GENERAL PRACTICE
N-7036 05 AR
institution
Provider Business Practice Location Address Details
Address
12609 Saint Charles Blvd
City
State
Zip
72211-2227
Phone Number
501-680-0738
Fax Number
person
Provider Business Mailing Address Details
Address
12609 Saint Charles Blvd
City
State
Zip
72211-2227
Phone Number
501-680-0738
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Pediatric Surgery
Taxonomy
License No.
N-7036 (Arkansas)
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
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