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Dr. Derrick Durell Wagoner, DO
Diagnostic Radiology Physician in Edmond, Oklahoma
NPI 1760829220

Derrick Durell Wagoner is a Diagnostic Radiology Physician based in Horseheads, OK and is specialized in Diagnostic Radiology. Derrick Durell Wagoner practices in Edmond, OK and has the professional credentials of DO. The NPI Number for Derrick Durell Wagoner is 1760829220 and holds a License No. 6324 (Oklahoma).

The current practice location address for Derrick Durell Wagoner is 1800 Renaissance Blvd Ste 110, Edmond, OK and can be reached out via phone at 405-601-2325.

Location: 1800 Renaissance Blvd Ste 110, Edmond, OK, 14845-1918
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Provider Profile Details
NPI Number
1760829220
Provider Name
Derrick Durell Wagoner
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1800 Renaissance Blvd Ste 110, Edmond, OK, 14845-1918
Phone Number
405-601-2325
Fax Number
Provider Enumeration Date
05/23/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200769850A 05 OK
institution
Provider Business Practice Location Address Details
Address
1800 Renaissance Blvd Ste 110
City
State
Zip
73013
Phone Number
405-601-2325
Fax Number
person
Provider Business Mailing Address Details
Address
1800 Renaissance Blvd Ste 110
City
State
Zip
73013
Phone Number
405-601-2325
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
6324 (Oklahoma)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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