Clarence H Wagoner Jr. (NPI# 1235126400, PAC ID# 4587564414) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST.
| Nation Provider ID (NPI) | 1235126400 |
| PAC ID by PECOS | 4587564414 |
| Professional Enrollment ID | I20040108001148 |
| Full Name | Clarence H Wagoner Jr. |
| Organization Legal Name | J. ARTHUR DOSHER MEMORIAL HOSPITAL |
| Address |
924 N Howe St Southport NC 28461-3038 |
| Phone Number | 9104573800 |
| Gender | M |
| Credential | CNA |
| Graduation Year | 1994 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST |
| Group Practice PAC ID | 8921910324 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 341327 | J ARTHUR DOSHER MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 924 N Howe St, Southport, NC 28461-3038 | 9104573800 | J. ARTHUR DOSHER MEMORIAL HOSPITAL |
| Organization Legal Name | J. ARTHUR DOSHER MEMORIAL HOSPITAL |
| Physicians | 35 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Reynolds | Nurse Practitioner | J. Arthur Dosher Memorial Hospital | 1513 N Howe St, Suite 6, Southport, NC 28461-2770 |
| Sally Delmastro | Nurse Practitioner | J. Arthur Dosher Memorial Hospital | 4700 E Oak Island Dr, Oak Island, NC 28465-5257 |
| Anthony A Clare | Physician Assistant | J. Arthur Dosher Memorial Hospital | 905 N Howe St, Southport, NC 28461-3037 |
| Heather Bowers Goldfuss | Physician Assistant | J. Arthur Dosher Memorial Hospital | 3009 Medical Plaza Lane, Southport, NC 28461-3038 |
| James K Weingarten | Emergency Medicine | J. Arthur Dosher Memorial Hospital | 906 N Howe St, Southport, NC 28461-3038 |
| Brad Lee Hilaman | Obstetrics/gynecology | J. Arthur Dosher Memorial Hospital | 823 N Atlantic Ave, Southport, NC 28461-3531 |
| Sharon L Vinson | Certified Registered Nurse Anesthetist (crna) | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Sheetal H Patel | Internal Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Kristos N Vaughan | Family Medicine | J. Arthur Dosher Memorial Hospital | 3009 Medical Plaza Lane, Southport, NC 28461-3038 |
| Richard S Carley | Emergency Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Street Address |
924 N HOWE ST |
| City | SOUTHPORT |
| State | NC |
| Zip | 28461-3038 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharon L Vinson | Certified Registered Nurse Anesthetist (crna) | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Sheetal H Patel | Internal Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Richard S Carley | Emergency Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Andre Leameac Minor | General Practice | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Robert M Zukoski | General Surgery | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Tana B Jenkins | Certified Registered Nurse Anesthetist (crna) | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Elmira Sadeghi Razlighi Basaly | Internal Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Brian S Phelps | Certified Registered Nurse Anesthetist (crna) | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Karen H Chance | Nurse Practitioner | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| John A Burdette | Emergency Medicine | J. Arthur Dosher Memorial Hospital | 924 N Howe St, Southport, NC 28461-3038 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lana Simmons | Nurse Practitioner | Novant Medical Group Inc | 2950 Pine Plantation Pkwy, Oak Island, NC 28461-0119 |
| Sara E Clagg | Nurse Practitioner | Novant Medical Group Inc | 2950 Pine Plantation Pkwy, Oak Island, NC 28461-0119 |
| Joyce Pilar Johnson | Family Medicine | Novant Medical Group Inc | 2950 Pine Plantation Pkwy, Oak Island, NC 28461-0119 |
| Scott Lionel Girard | Hospitalist | Novant Medical Group Inc | 2950 Pine Plantation Pkwy, Oak Island, NC 28461-0119 |
| Barton Schneyer | Pulmonary Disease | Southport Pulmonary Medicine Pllc | 1517 N Howe St, Suite 12, Southport, NC 28461-2608 |
| Cheryl N Owen | Nurse Practitioner | Southport Pulmonary Medicine Pllc | 1517 N Howe St, Suite 12, Southport, NC 28461-2608 |
| Melissa A Denman | Nurse Practitioner | Southport Pulmonary Medicine Pllc | 1517 N Howe St, Suite 12, Southport, NC 28461-2608 |
| Phillip David Khan | Plastic and Reconstructive Surgery | Novant Medical Group Inc | 1456 N Howe St, Suite 201, Southport, NC 28461-2672 |
| Matthew J Lucas | Nurse Practitioner | Novant Medical Group Inc | 1456 N Howe St, Suite 201, Southport, NC 28461-2672 |
| Ryan C Tighe | Family Medicine | Novant Medical Group Inc | 1456 N Howe St, Suite 201, Southport, NC 28461-2674 |
| Find all physicians in zip 28461 | |||
| City | SOUTHPORT |
| Zip Code | 28461 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST |
| City + Specialty | SOUTHPORT + CERTIFIED REGISTERED NURSE ANESTHETIST |
Please comment or provide details below to improve the information on Clarence H Wagoner Jr..
| 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.