MEDICARE: DR. ALTON HARVEY WAGNON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	84-171442-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84-171442-1205	OTHER	UT	STATE LICENSE NO.

General Provider Information

NPI Number	:	1750380176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALTON HARVEY WAGNON M.D.

Provider Business Mailing Address
First Line	:	5309 MOHAWK CIR
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84403-4602
Country	:	US
Telephone Number	:	801-393-4266
Fax Number	:

Provider Business Practice Location Address
First Line	:	2890 E COTTONWOOD PKWY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-7035
Country	:	US
Telephone Number	:	801-333-5357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/07/2023

Similar Medicare Providers

1750412896 — CHRISTINA ROYEL HEINER R.PH., MBA
Practice Location Address:

2890 E COTTONWOOD PKWY , #81
SALT LAKE CITY, UT
84121-7035

Practice Phone: 801-333-5562
Practice Fax: 801-333-6558

1578693685 — MR. ALAN SAMUEL ARONOVITZ RPH
Practice Location Address:

7035 VENTNOR GARDENS PLZ
VENTNOR CITY, NJ
08406-1627

Practice Phone: 609-823-8309
Practice Fax:

1033354782 — SANLO ORTHOPEDICS LLC
Practice Location Address:

7035 E. RENO AVE.
MIDWEST CITY, OK
73110

Practice Phone: 405-610-6171
Practice Fax: 405-610-6173

1942188560 — DR. VERONICA VILLALOBOS SMITH OTD, OTR/L
Practice Location Address:

3034 TRIBUTARY LN
ROYSE CITY, TX
75189-7035

Practice Phone: 210-238-5319
Practice Fax:

1316814486 — MARIA RENATA PERROGON
Practice Location Address:

948 FLYER ST
ORANGE CITY, FL
32763-7035

Practice Phone: 407-529-6208
Practice Fax:

1487740544 — DAVID AARON SKLAR
Practice Location Address:

14731 MANHATTAN PL , 7035 ORCHARD LAKE ROAD SUITE 550
OAK PARK, MI
48237-1017

Practice Phone: 248-808-0283
Practice Fax: 248-808-0283

Directions to “ DR. ALTON HARVEY WAGNON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.