JACKSON D. WAGNON, M.D.P.A. (NPI# 1679793350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679793350 |
| Entity Type | Organization |
| Organization Name | JACKSON D. WAGNON, M.D.P.A. |
| Practice Address |
208 Gaslight Blvd Lufkin TX 75904-3166 |
| Practice Telephone | 9366348800 |
| Practice Fax Number | 9366348836 |
| Mailing Telephone | 9366348800 |
| Mailing Fax Number | 9366348836 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | DR. JACKSON WAGNON (PHYSICIAN) |
| Authorized Official Telephone | 9366348800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | G43680 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 144108101 | 05 |
| Street Address |
208 GASLIGHT BLVD |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295730323 | Peter Wells Ross | Legal Medicine | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2005-06-15 |
| 1881072833 | Doctx1 Pllc | Physical Medicine & Rehabilitation | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2015-05-11 |
| 1245594563 | Shelby Elizabeth Bryan | Specialist/Technologist, Other | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2012-07-02 |
| 1154682839 | Kristopher Blake Mccall | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2012-05-30 |
| 1184991317 | Derek W. Harper | Physician Assistant | 208 Gaslight Blvd, Suite B, Lufkin, TX 75904-3166 | 2011-11-16 |
| 1497084065 | Robert M Lindsey,m.d.p.a. | Physical Medicine & Rehabilitation | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2009-12-10 |
| 1689902231 | Texas Specialist Center Pllc | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2009-11-19 |
| 1831321405 | Jason Daniel Carter,m.d.p.a. | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2009-08-17 |
| 1780834135 | Merritt Pember Md Pa | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2008-09-23 |
| 1013185487 | J. Dan Carter, M.d., P.a. | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2008-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154682839 | Kristopher Blake Mccall | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2012-05-30 |
| 1689902231 | Texas Specialist Center Pllc | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2009-11-19 |
| 1831321405 | Jason Daniel Carter,m.d.p.a. | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2009-08-17 |
| 1780834135 | Merritt Pember Md Pa | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2008-09-23 |
| 1013185487 | J. Dan Carter, M.d., P.a. | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2008-02-19 |
| 1871715490 | Roy J. Guse, M.d.p.a. | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2007-05-03 |
| 1376629154 | John Daniel Carter | Orthopaedic Surgery | 208 Gaslight Blvd, Suite 2, Lufkin, TX 75904-3166 | 2006-10-27 |
| 1063447407 | Jason D Carter | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2006-07-12 |
| 1386684645 | Jackson D Wagnon | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2006-06-07 |
| 1336189562 | Daniel Fuentes | Orthopaedic Surgery | 208 Gaslight Blvd, Lufkin, TX 75904-3166 | 2006-06-07 |
| Find all providers in LUFKIN | ||||
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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.