DERRICK D. WAGONER D.O. – NPI #1760829220
Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
DERRICK WAGONER is a radiologist located in EDMOND, OK. NPPES has assigned the NPI number 1760829220 to DERRICK WAGONER on May 23, 2013. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology
The NPI profile was last updated on Aug 29, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DERRICK WAGONER below.
NPI Profile for
DERRICK D. WAGONER
(more than 13 years ago)
EDMOND, OK 73013 Phone: (405) 601-2325 Fax:
1 Other location(s):
Williamsville, NY 14221-8243
Phone: (716) 630-1000
HORSEHEADS, NY 14845-1918 Phone: Fax:
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for DERRICK WAGONER
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| medicaid | OK | 200769850A |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 2085R0202X - Radiology / Diagnostic Radiology (Primary) |
OK | 6324 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
DERRICK WAGONER is affiliated with the following medical group(s):
- HOSPITAL
- ARNOT OGDEN MEDICAL CENTER600 ROE AVENUE
ELMIRA, NY 14905 - IRA DAVENPORT MEMORIAL HOSPITAL7571 STATE ROUTE 54
BATH, NY 14810 - SENTARA PRINCESS ANNE HOSPITAL2025 GLENN MITCHELL DRIVE
VIRGINIA BEACH, VA 23456 - SENTARA VIRGINIA BEACH GENERAL HOSPITAL1060 FIRST COLONIAL ROAD
VIRGINIA BEACH, VA 23454
- ARNOT OGDEN MEDICAL CENTER600 ROE AVENUE
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