DR. ALTON HARVEY WAGNON


Address: 2890 E Cottonwood Pkwy, Salt Lake City, UT 84121-7035
Phone: 8013335357

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
84-171442-1205 UT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
UT DEA NUMBER AW2653168 01
UT STATE LICENSE NO. 84-171442-1205 01

Office Location

Street Address 2890 E COTTONWOOD PKWY
City SALT LAKE CITY
State UT
Zip Code 84121-7035

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750412896 Christina Royel Heiner Pharmacist 2890 E Cottonwood Pkwy, #81, Salt Lake City, UT 84121-7035 2007-03-08

Providers in the same zip code

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 Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City SALT LAKE CITY
Zip Code 84121

Improve Information

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Dataset Information

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.

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