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John Wagner, MD
Child & Adolescent Psychiatry Physician in Shreveport, Louisiana
NPI 1033320577

John Wagner is a Child & Adolescent Psychiatry Physician based in Shreveport, LA and is specialized in Child & Adolescent Psychiatry. John Wagner practices in Shreveport, LA and has the professional credentials of MD. The NPI Number for John Wagner is 1033320577 and holds a License No. MD.201230 (Louisiana).

The current practice location address for John Wagner is 7330 Fern Ave Ste 704, Shreveport, LA and can be reached out via phone at 318-798-8261 and via fax at 316-798-8263.

Location: 7330 Fern Ave Ste 704, Shreveport, LA, 71105-4985
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033320577
Provider Name
John Wagner
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
7330 Fern Ave Ste 704, Shreveport, LA, 71105-4985
Phone Number
318-798-8261
Fax Number
316-798-8263
Provider Enumeration Date
05/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1214841 05 LA
4P278F600 01 LA MEDICARE - PTAN
institution
Provider Business Practice Location Address Details
Address
7330 Fern Ave Ste 704
City
Shreveport
State
Louisiana
Zip
71105-4985
Phone Number
318-798-8261
Fax Number
316-798-8263
person
Provider Business Mailing Address Details
Address
7330 Fern Ave Ste 704
City
Shreveport
State
Louisiana
Zip
71105-4985
Phone Number
318-798-8261
Fax Number
316-798-8263
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Child & Adolescent Psychiatry
Taxonomy
2084P0804X
License No.
MD.201230 (Louisiana)
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
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