DR. DOUGLAS B WIDENER (NPI# 1104088566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104088566 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS B WIDENER |
| Credential | M.D. |
| Practice Address |
1495 Hickory Flat Hwy Ste 200 Canton GA 30115-4229 |
| Practice Telephone | 6785054455 |
| Practice Fax Number | 6785054446 |
| Mailing Telephone | 6785054455 |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 063452 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1495 HICKORY FLAT HWY STE 200 |
| City | CANTON |
| State | GA |
| Zip Code | 30115-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053849448 | Resurgens, PC | Orthopaedic Surgery | 1495 Hickory Flat Hwy Ste 200, Canton, GA 30115-4229 | 2017-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
| 1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
| 1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
| 1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
| 1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
| 1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
| 1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
| 1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
| 1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
| 1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
| Find all providers in zip 30115 | ||||
| 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 |
|---|---|---|---|---|
| 1669816906 | Brett Marshall Hall | Orthopaedic Surgery | 15 Reinhardt College Pkwy Ste 108, Canton, GA 30114-5259 | 2013-04-17 |
| 1053531624 | David D Smith | Orthopaedic Surgery | 6488 St Augustine Dr Nw, Canton, OH 44718 | 2007-04-26 |
| 1477674877 | Brian Elliot Seng | Orthopaedic Surgery | 470 Northside Cherokee Blvd Ste 160, Canton, GA 30115-8029 | 2007-04-03 |
| 1255478079 | Soni Orthopaedic Clinic Inc | Orthopaedic Surgery | 1900 Fulton Rd Nw, Canton, OH 44709-3526 | 2007-01-31 |
| 1629036389 | Robert Daniel Travis | Orthopaedic Surgery | 44633 Joy Rd, Suite 200, Canton, MI 48187-1730 | 2006-05-03 |
| 1457311755 | John B Savage | Orthopaedic Surgery | 6119 St Highway Rt 11, Canton, NY 13617 | 2006-03-23 |
| 1477537934 | Douglas W Clanton | Orthopaedic Surgery | 230 Marietta Hwy, Suite 100, Canton, GA 30114 | 2005-11-30 |
| 1093705063 | Daniel Alexander Charlick | Orthopaedic Surgery | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2005-10-21 |
| 1629060215 | Dennis Allen Glazer | Orthopaedic Surgery | 3030 Tuscarawas St W, Suite 300, Canton, OH 44708-4167 | 2005-08-18 |
| 1053849448 | Resurgens, PC | Orthopaedic Surgery | 1495 Hickory Flat Hwy Ste 200, Canton, GA 30115-4229 | 2017-05-30 |
| Find all providers in CANTON | ||||
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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.