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

Jack C Wagner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1093510810

Jack C Wagner is a Student in an Organized Health Care Education/Training Program in Oklahoma City, Oklahoma. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

2200 N Classen Blvd
Oklahoma City, OK 73106-5800
Phone: (405) 760-2673
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1093510810
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 17, 2025
Last updated in NPPESFebruary 17, 2025
Certification dateFebruary 16, 2025

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