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

Dr. Jack Wagoner, MD

Individual provider Anesthesiology Physician · NPI 1598700072

Dr. Jack Wagoner, MD is an Anesthesiology in Jackson, Michigan. Qualified in 1986, 40 years ago. Practices with Anesthesia Associates of Ann Arbor PLLC, a 217-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
40
Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

205 N East Ave
Jackson, MI 49201-1753
Phone: (517) 788-4963
Fax: (517) 789-5903
Show map & directions

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

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 4301-407025 (MI)

Record details

NPI number1598700072
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 18, 2006
Last updated in NPPESNovember 6, 2007
Mailing address205 N East Ave, Jackson, MI 49201-1753

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Anesthesia Associates Of Ann Arbor Pllc — 217 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Jackson