CHARLES WAYNE HARTZOG JR. (NPI# 1952388050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952388050 |
| Entity Type | Individual |
| Full Name | CHARLES WAYNE HARTZOG JR. |
| Credential | MD |
| Practice Address |
4294 Lomac St Montgomery AL 36106-3604 |
| Mailing Address |
Po Box 235003 Montgomery AL 36123-5003 |
| Practice Telephone | 3342749000 |
| Practice Fax Number | 3342740857 |
| Mailing Telephone | 3342749000 |
| Mailing Fax Number | 3342740857 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2008-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 20880 | AL | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
20880 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED HEALTHCARE | 0910085 | 01 | |
| RR MEDICARE | 200028175 | 01 | |
| PRIME HEALTH | 551322 | 01 | |
| FIRST HEALTH | 940627 | 01 | |
| BLUE CROSS | 51032697 | 01 | |
| BLUE CROSS | 51032885 | 01 | |
| AL | 000032885 | 05 | |
| AETNA | 5977258 | 01 | |
| AL | 000032697 | 05 | |
| NCC/TYNET | 6455 | 01 |
| Street Address |
4294 LOMAC ST |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-3604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952386740 | Thomas George Wells | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-14 |
| 1518528298 | Jessica Burley Wilson | Nurse Practitioner | 4294 Lomac St, Montgomery, AL 36106-3604 | 2019-06-24 |
| 1952582835 | Hussein W Turki Jr. | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2007-11-19 |
| 1033267471 | Alabama Orthopaedic Specialists, P.a. | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2007-01-08 |
| 1144207291 | Donald Davis Thornbury Jr. | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-29 |
| 1093792079 | Edward Eaton Palmer Jr. | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-29 |
| 1376520742 | George Dexter Walcott Jr. | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-28 |
| 1154308690 | Edward Joseph Woods | Physician Assistant | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-27 |
| 1700863248 | Steven Allen Barrington | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-27 |
| 1619954153 | Michael Edward Davis | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747205 | Rural Urgent Care LLC | Clinic/Center | 3039 Vaughn Road, Montgomery, AL 36106 | 2020-07-16 |
| 1548733306 | Bennett Family Dentistry, LLC | Dentist | 4270 Carmichael Road, Montgomery, AL 36106 | 2019-01-04 |
| 1588133854 | Lori Leanne Fail | Physical Therapist | 1615 Windsor Hill Court, Montgomery, AL 36106 | 2018-11-16 |
| 1073020749 | Charlene Richmond Harrell | Chiropractor | 2900 Zelda Rd., Suite A, Montgomery, AL 36106 | 2018-01-03 |
| 1780123109 | Montgomery Accident and Injury Center, Inc | Nurse Practitioner | 2900 Zelda Rd, Ste B, Montgomery, AL 36106 | 2017-02-17 |
| 1467843573 | Ernest Porterfield | Non-emergency Medical Transport (VAN) | 4183 Carmichael Road, Suite A, Montgomery, AL 36106 | 2015-02-11 |
| 1114334281 | Daniel Gerald O'bryant | Specialist/Technologist | 1160 Navarro Avenue, Montgomery, AL 36106 | 2014-07-21 |
| 1801213764 | Amanda Hodge | Specialist/Technologist | 4605 Cherry Tree Terrace, Montgomery, AL 36106 | 2014-03-27 |
| 1871861542 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1758 Park Pl Ste 102, Montgomery, AL 36106 | 2011-12-08 |
| 1578862546 | Helping Hands Preventitive Health Center | Community/Behavioral Health | 2015 Mulberry St, Montgomery, AL 36106 | 2011-03-16 |
| Find all providers in zip 36106 | ||||
| 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 |
|---|---|---|---|---|
| 1972755155 | Alabama Orthopaedic Specialists, P.a. | Orthopaedic Surgery | 4630 Woodmere Blvd., Montgomery, AL 36106-2906 | 2008-10-21 |
| 1477733269 | Wilburn A. Smith, Jr., M.d. | Orthopaedic Surgery | 4131 Carmichael Rd, Suite 28, Montgomery, AL 36106-2801 | 2007-11-08 |
| 1528263415 | Randall Lee Murphy Jr. | Orthopaedic Surgery | 2257 Taylor Rd Ste 125, Montgomery, AL 36117-7790 | 2007-06-19 |
| 1861618738 | Saghir Ur Rehman Mir | Orthopaedic Surgery | 401 6th Avenue, Suite 302, Montgomery, WV 25136 | 2007-04-18 |
| 1083776199 | Wilburn Anthony Smith | Orthopaedic Surgery | 2023 Normandie Dr, Montgomery, AL 36111-2711 | 2006-12-14 |
| 1841385663 | Tai Chung | Orthopaedic Surgery | 6936 Winton Blount Blvd, Montgomery, AL 36117-3555 | 2006-10-04 |
| 1487614665 | Samuel L Miller | Orthopaedic Surgery | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2409 | 2006-03-23 |
| 1790744589 | Joseph F Curtis Jr. | Orthopaedic Surgery | 454 Taylor Rd, Montgomery, AL 36117-3563 | 2006-03-21 |
| 1437118254 | Donald F Hodurski | Orthopaedic Surgery | 101 S Union St, Montgomery, AL 36130-3022 | 2006-03-21 |
| 1952386740 | Thomas George Wells | Orthopaedic Surgery | 4294 Lomac St, Montgomery, AL 36106-3604 | 2005-12-14 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36106 |
Please comment or provide details below to improve the information on CHARLES WAYNE HARTZOG JR..
| 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.