Individual
DR. ALTON HARVEY WAGNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2890 E COTTONWOOD PKWY, SALT LAKE CITY, UT 84121-7035
(801) 333-5357
Mailing address
5309 MOHAWK CIR, OGDEN, UT 84403-4602
(801) 393-4266
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
84-171442-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-171442-1205
STATE LICENSE NO.
UT
Enumeration date
07/18/2005
Last updated
03/07/2023
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