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

Kyle Alexander Wagner, PA-C

Individual provider Physician Assistant · NPI 1104598895

Kyle Alexander Wagner, PA-C is a Physician Assistant in Fort Campbell, Kentucky. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone: (805) 206-8883
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104598895
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 30, 2021
Last updated in NPPESNovember 4, 2022
Certification dateNovember 4, 2022

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