DR. ALTON HARVEY WAGNON (NPI# 1750380176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750380176 |
| Entity Type | Individual |
| Full Name | DR. ALTON HARVEY WAGNON |
| Credential | M.D. |
| Practice Address |
2890 E Cottonwood Pkwy Salt Lake City UT 84121-7035 |
| Mailing Address |
5309 Mohawk Cir Ogden UT 84403-4602 |
| Practice Telephone | 8013335357 |
| Mailing Telephone | 8013934266 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
84-171442-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | DEA NUMBER | AW2653168 | 01 |
| UT | STATE LICENSE NO. | 84-171442-1205 | 01 |
| Street Address |
2890 E COTTONWOOD PKWY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-7035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750412896 | Christina Royel Heiner | Pharmacist | 2890 E Cottonwood Pkwy, #81, Salt Lake City, UT 84121-7035 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123172 | Scott Marriner Browning | Internal Medicine | 2318 E Field Rose Dr, Salt Lake City, UT 84121-1500 | 2017-06-08 |
| 1356745137 | University of Utah Adult Services | Internal Medicine | 1950 E Circle of Hope Drive, Salt Lake City, UT 84112 | 2014-10-22 |
| 1982049227 | Bryan D Huber | Internal Medicine | 8th Avenue & C Street E8, Salt Lake City, UT 84143-3403 | 2013-04-30 |
| 1457664005 | Sabarinath Venniyil Radhakrishna | Internal Medicine | 2000 Circle of Hope, Suite 2100, Huntsman Cancer Institute, Salt Lake City, UT 84112 | 2010-07-23 |
| 1225164114 | Finn Bo Petersen | Internal Medicine | E8 Lds Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143-0001 | 2007-02-26 |
| 1699775767 | Sunil Sharma | Internal Medicine | 2000 Circle of Hope Dr, #3380, Salt Lake City, UT 84112-5550 | 2005-07-29 |
| 1679094700 | Haoran Li | Internal Medicine | 30 N 1900 E Rm 5c402, Salt Lake City, UT 84132-0002 | 2017-06-28 |
| 1912435579 | Shashank Sama | Internal Medicine | 30 N 1900 E Rm 5c402, Salt Lake City, UT 84132-0002 | 2017-05-26 |
| 1487018040 | University of Utah Pediatric Services | Internal Medicine | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1164885083 | Kristen Kelley | Internal Medicine | 30 N 1900 E Rm 5c402, Salt Lake City, UT 84132-0002 | 2016-03-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on DR. ALTON HARVEY WAGNON.
| 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.