Kyle Alexander Wagner, PA-C
NPI #1104598895 in Fort Campbell, Kentucky
Provider Information
- NPI Number
- 1104598895
- Entity Type
- Individual
- Name
- Kyle Alexander Wagner, PA-C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Sep 30, 2021
- Last Updated
- Nov 4, 2022
Practice Location
- Address
- 650 JOEL DR
- City
- Fort Campbell
- State
- Kentucky
- ZIP Code
- 42223-5318
- Phone
- (805) 206-8883
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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