Richard W Wagoner (NPI# 1861458952, PAC ID# 7416085675) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1861458952 |
| PAC ID by PECOS | 7416085675 |
| Professional Enrollment ID | I20100507000571 |
| Full Name | Richard W Wagoner |
| Organization Legal Name | MASON HOSPITAL DISTRICT |
| Address |
615 N Promenade Havana IL 62644-1243 |
| Phone Number | 3095438542 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 2466360607 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141313 | MASON DISTRICT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 615 N Promenade, Havana, IL 62644-1243 | 3095438542 | MASON HOSPITAL DISTRICT |
| Organization Legal Name | MASON HOSPITAL DISTRICT |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carlos Alberto Urdininea Kirkwood | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Crystal R Falke | Physician Assistant | Mason Hospital District | 122 E Elm St, Mason City, IL 62664-1410 |
| Cristy M Lane | Nurse Practitioner | Mason Hospital District | 1301 S E Ave, Manito, IL 61546-8909 |
| Kayla R Miller | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| John Quinones | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Julius P Bonello | General Surgery | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Tad A Yetter | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Bethany L Bitner | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Bruce W Schultz | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Nancy Mueller Fleenor | Nurse Practitioner | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Street Address |
615 N PROMENADE |
| City | HAVANA |
| State | IL |
| Zip | 62644-1243 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carlos Alberto Urdininea Kirkwood | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Kayla R Miller | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| John Quinones | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Julius P Bonello | General Surgery | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Tad A Yetter | Internal Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Bethany L Bitner | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Bruce W Schultz | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Nancy Mueller Fleenor | Nurse Practitioner | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| James T Brown | Emergency Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Michael S Markley | Family Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony D Roberts | Chiropractic | 303 W Main St, Havana, IL 62644-1139 | |
| Renold B Bleem | Chiropractic | 314 W Main St, Havana, IL 62644-1140 | |
| Daniel P Stoops | Emergency Medicine | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Kathryn A Fry | Nurse Practitioner | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Brent D Parry | Podiatry | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| Chase A Holtman | Nurse Practitioner | Mason Hospital District | 615 N Promenade, Havana, IL 62644-1243 |
| City | HAVANA |
| Zip Code | 62644 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | HAVANA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Richard W Wagoner.
| 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.