DR. MICHAEL DEGON (NPI# 1619100856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619100856 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DEGON |
| Credential | M.D. |
| Practice Address |
6600 Van Aalst Blvd Martin Army Community Hospital, Urology Service Fort Benning GA 31905-0000 |
| Practice Telephone | 7624083566 |
| Mailing Telephone | 7624083566 |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2019-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | 074953 | GA | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | 0101249213 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
6600 VAN AALST BLVD MARTIN ARMY COMMUNITY HOSPITAL, UROLOGY SERVICE |
| City | FORT BENNING |
| State | GA |
| Zip Code | 31905-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184608218 | Fletcher Maurice Boulware Jr. | Anesthesiology | 6600 Van Aalst Blvd, Anesthesia Suite 2nd Floor, Fort Benning, GA 31905 | 2005-12-01 |
| 1700486669 | Krystal Smith Dabon | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-29 |
| 1508466731 | Nichelle Pascoe | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-27 |
| 1598372518 | Delli Dorne | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-24 |
| 1205442944 | Vincent Krause | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-18 |
| 1578175824 | Shawn Nguyen | Optometrist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-08-18 |
| 1720606791 | Aylin Seyalioglu | Physical Therapist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-07-07 |
| 1578187431 | Travis Ian Hallquist | Registered Nurse | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-06-05 |
| 1770121899 | Rachel Elizabeth Cobb | Audiologist-Hearing Aid Fitter | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-12-19 |
| 1518516657 | Emily L Derosa | Physician Assistant | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
| 1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
| 1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
| 1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
| 1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
| 1356897953 | Katelyn Dolezal | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-09-01 |
| 1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
| 1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
| 1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
| 1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
| Find all providers in zip 31905 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1790248953 | Michael Oberle | Urology | 1120 15th St Rm Baa 8415, Augusta, GA 30912-4050 | 2019-04-12 |
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| 1275008351 | Center for Special Surgery LLC | Urology | 11660 Alpharetta Hwy Ste 720, Roswell, GA 30076-4916 | 2018-10-04 |
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
| 1982182655 | Advanced Urology Institute of Georgia | Urology | 1460 S Johnson Ferry Rd, Atlanta, GA 30319-4301 | 2018-08-03 |
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
| Find all providers with the same taxonomy | ||||
| City | FORT BENNING |
| Zip Code | 31905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.