DR. SETH T WAGNER (NPI# 1659506277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659506277 |
| Entity Type | Individual |
| Full Name | DR. SETH T WAGNER |
| Credential | D.O. |
| Practice Address |
1114 Professional Blvd Dalton GA 30720 |
| Practice Telephone | 7062780138 |
| Practice Fax Number | 7062723780 |
| Mailing Telephone | 7062780138 |
| Mailing Fax Number | 7062723780 |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2017-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 070602 | GA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | D02265 | TN | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 070602 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003398959 | Seth Christopher Wagner | Nurse Practitioner | 184 Barton St, Buffalo, NY 14213-1573 | 2018-09-06 |
| 1548747827 | Seth Wagner | Behavior Technician | Rr 61 Box 3030, Naylor, MO 63953-9414 | 2018-07-19 |
| Street Address |
1114 PROFESSIONAL BLVD |
| City | DALTON |
| State | GA |
| Zip Code | 30720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134117609 | Douglas Bradley Delay | Family Medicine | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2005-10-10 |
| 1669087615 | Taylor Nicole Efaw | Physician Assistant | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2020-09-15 |
| 1912266230 | Jennifer Nicole Duckett | Physician Assistant | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2012-05-07 |
| 1497998223 | Brandon Alan Smith | Internal Medicine | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2009-04-09 |
| 1801061452 | Justin Price Burgett | Registered Nurse | 1114 Professional Blvd, Dalton, GA 30720-2597 | 2008-04-24 |
| 1649338849 | Brandy Michelle Scott | Physician Assistant | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2006-12-04 |
| 1639167026 | Dalton Family Practice, P.C. | Family Medicine | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2005-10-10 |
| 1851389340 | Stanley L Hoy | Internal Medicine | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2005-10-10 |
| 1285622746 | Karah Freeman Smith | Physician Assistant | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2005-10-10 |
| 1265420731 | John S Antalis | Family Medicine | 1114 Professional Blvd, Dalton, GA 30720-2588 | 2005-10-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1578833422 | Glenn H Boyd Md PC | Internal Medicine | 1203 Memorial Drive, Dalton, GA 30720-2530 | 2012-01-10 |
| 1629308416 | Michael John Quinn | Internal Medicine | 148 Sleepy Hollow Drive, Dalton, MA 01226-2065 | 2009-12-30 |
| 1508941857 | Carlton Delk Lancaster Jr. | Internal Medicine | 1109 Burleyson Dr Suite 103, Dalton, GA 30720-3099 | 2006-10-26 |
| 1942393327 | German Jose Garcia | Internal Medicine | 1143 E Walnut Ave, Dalton, GA 30721-4172 | 2006-09-30 |
| 1942218086 | Pablo E Perez | Internal Medicine | 1102 W. Waugh St, Dalton, GA 30720 | 2006-08-04 |
| 1164451209 | Francisco Castaneda | Internal Medicine | 1401 Applewood Dr, Suite 1, Dalton, GA 30720 | 2006-07-01 |
| 1437105046 | Azhar Nisar | Internal Medicine | 1407 Chattanooga Ave, Suite B, Dalton, GA 30720-2631 | 2006-05-25 |
| 1093763682 | Glenn H Boyd | Internal Medicine | 1203 Memorial Dr, Dalton, GA 30720-2530 | 2006-05-05 |
| 1174512321 | Julia Garcia | Internal Medicine | 1217 Memorial Dr, Dalton, GA 30720-2535 | 2005-10-20 |
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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.