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

Dylan Paul Wagner, PA

Individual provider Medical Physician Assistant · NPI 1992058556

Dylan Paul Wagner, PA is a Physician Assistant in Laurel, Mississippi. Qualified in 2012, 14 years ago. Practices with Hattiesburg Clinic PA, a 530-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
14
Licensed in
MS
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2313 Highway 15 N
Laurel, MS 39440-1805
Phone: (601) 649-2775
Fax: (601) 649-2686
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 00172 (MS)

Record details

NPI number1992058556
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 19, 2012
Last updated in NPPESJuly 23, 2020
Certification dateJuly 23, 2020
Mailing address415 S 28th Ave, Hattiesburg, MS 39401-7246

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Hattiesburg Clinic Pa — 530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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