Douglas S Wagner (NPI# 1356302426, PAC ID# 2961401245) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1356302426 |
| PAC ID by PECOS | 2961401245 |
| Professional Enrollment ID | I20100601000077 |
| Full Name | Douglas S Wagner |
| Organization Legal Name | CRYSTAL CLINIC, INC. |
| Address |
3925 Embassy Pkwy Akron OH 44333-1782 |
| Phone Number | 3306684050 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1981 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 7214821586 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360351 | CRYSTAL CLINIC ORTHOPAEDIC CENTER |
| 360020 | SUMMA HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 3925 Embassy Pkwy, Akron, OH 44333-1782 | 3306684050 | CRYSTAL CLINIC, INC. |
| Organization Legal Name | CRYSTAL CLINIC, INC. |
| Physicians | 47 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Derek G Cody | Plastic and Reconstructive Surgery | Crystal Clinic, Inc. | 437 Portage Trail, Cuyahoga Falls, OH 44221-3227 |
| Michael G Parker | Plastic and Reconstructive Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1782 |
| Mark M Musgrave | Orthopedic Surgery | Crystal Clinic, Inc. | 4975 Foote Rd, Suite 100, Medina, OH 44256-8748 |
| Ian M Gradisar | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Gary A Pennington | Plastic and Reconstructive Surgery | Crystal Clinic, Inc. | 72 5th St Se A, Barberton, OH 44203-4201 |
| Douglas M Ehrler | Orthopedic Surgery | Crystal Clinic, Inc. | 2007 State Route 59, Kent, OH 44240-7610 |
| Thomas J Reilly Jr. | Hand Surgery | Crystal Clinic, Inc. | 1325 Corporate Dr, A, Hudson, OH 44236-4432 |
| John W Dietrich | Hand Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1763 |
| James P Kennedy | Orthopedic Surgery | Crystal Clinic, Inc. | 72 5th St Se A, Barberton, OH 44203-4201 |
| Michael R Magoline | Orthopedic Surgery | Crystal Clinic, Inc. | 437 Portage Trail, Cuyahoga Falls, OH 44221-3227 |
| Street Address |
3925 EMBASSY PKWY |
| City | AKRON |
| State | OH |
| Zip | 44333-1782 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael G Parker | Plastic and Reconstructive Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1782 |
| John W Dietrich | Hand Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1763 |
| Mollie O Manley | Hand Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1763 |
| John X Biondi | Hand Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1782 |
| Scot D Miller | Orthopedic Surgery | Crystal Clinic, Inc. | 3925 Embassy Pkwy, Akron, OH 44333-1763 |
| Shayda Mirhaidari | Plastic and Reconstructive Surgery | Crystal Clinic Orthopaedic Center, LLC | 3925 Embassy Pkwy, 300 Crystal Plastic Surgeons, Akron, OH 44333-1799 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Beth Newey | Podiatry | 3451 Granger Rd, Akron, OH 44333-1532 | |
| Ian M Gradisar | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Brandy Mae Mansfield | Nurse Practitioner | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Kaitlyn A Wattley | Nurse Practitioner | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Kathleen Ann Opsitnick | Nurse Practitioner | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Jeffrey S Noble | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Matthew D Kay | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Phillip Lewandowski | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Kyle Nelman | Sports Medicine | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| David B Kay | Orthopedic Surgery | Crystal Clinic, Inc. | 3975 Embassy Pkwy, Suite 102, Akron, OH 44333-1763 |
| Find all physicians in zip 44333 | |||
| City | AKRON |
| Zip Code | 44333 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | AKRON + PLASTIC AND RECONSTRUCTIVE SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.