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

Dr. Derrick Durell Wagoner, DO

Individual provider Diagnostic Radiology Physician · NPI 1760829220

Dr. Derrick Durell Wagoner, DO is a Pain Management in Edmond, Oklahoma. Graduated from West Virginia School of Osteopathic Medicine in 2013, 13 years ago. Practices with Gershon Pain Specialists LLC, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
13
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
OK
In the registry since
2013
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1800 Renaissance Blvd Ste 110
Edmond, OK 73013
Phone: (405) 601-2325
Show map & directions

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

Additional practice locations (1)

  • 325 Essjay Rd, Williamsville, NY 14221-8243 — (716) 630-1000

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 6324 (OK)

Record details

NPI number1760829220
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 23, 2013
Last updated in NPPESAugust 29, 2025
Certification dateAugust 29, 2025
Mailing address321 Shappee St, Horseheads, NY 14845-1918

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPAIN MANAGEMENT
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2013 (13 years in practice)
Group practice Gershon Pain Specialists Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Edmond