National Provider Identifier Database

DERRICK D WAGONER, DO – NPI #1760829220
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

DERRICK D WAGONER, DO
1800 RENAISSANCE BLVD STE 110
EDMOND, OK73013
Phone: 405-601-2325
Fax:
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for DERRICK D WAGONER

NPI Number 1760829220
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/23/2013
Last updated 08/29/2025 - About 9 months ago
Sole proprietor1 Yes
Identifiers
  • OK License #: 6324
  • OK Medicaid: 200769850A
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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