person
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. You can also correspond with John Wagner through the mailing address at 7330 FERN AVE STE 704, SHREVEPORT, LA - 71105-4985 (mailing address contact number: 318-798-8261).

Location: 7330 Fern Ave Ste 704, Shreveport, LA, 71105-4985
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
State
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
State
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
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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