Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Waggoner OD PA

Organization Health Maintenance Organization · NPI 1992021190

Michael Waggoner OD PA is a Health Maintenance Organization in Fayetteville, Arkansas. Licensed in Arkansas. Registered with an NPI since 2010.

Licensed in
AR
In the registry since
2010
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2630 E Citizens Dr Ste 6
Fayetteville, AR 72703-4797
Phone: (479) 582-1212
Fax: (479) 582-2070
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Maintenance Organization (primary) Taxonomy 302R00000X · Licence 2411 (AR)

Record details

NPI number1992021190
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Waggoner — Owner · (479) 582-1212
NPI enumeratedApril 13, 2010
Last updated in NPPESAugust 12, 2015
Mailing address2630 E Citizens Dr Ste 6, Fayetteville, AR 72703-4797

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