Waggoner, Carl
Waggoner, Carl is an individual health care provider with primary practice located at 1272 W Main St Bldg. 5, Newark OH 43055-2034. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Waggoner, Carl can be contacted via phone (740) 348-1788.Contact Information
Primary practice address
1272 W Main St Bldg. 5
Newark OH 43055-2034
Phone: (740) 348-1788
Fax: (740) 348-1789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35-043176 | Ohio |
Profile Details
| NPI number | 1043218068 |
|---|---|
| LBN Legal business name | Waggoner, Carl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Jun 21st, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043218068 | NPPES |
| Ohio | Other | 0101480 | UHC |
| Ohio | Other | 1822763 | UHC |
| Ohio | MEDICAID | 416615 | UHC |
| Ohio | Other | 4400430 | UHC |
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