| Clinton Waggoner, MD | |
|
5151 N 9th Ave, Pensacola, FL 32504-8721 | |
| (850) 476-8602 | |
| (850) 474-3518 |
| Full Name | Clinton Waggoner |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 27 Years |
| Location | 5151 N 9th Ave, Pensacola, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235344011 | NPI | - | NPPES |
| 110982 | Medicaid | AL | |
| 111222 | Medicaid | AL | |
| 51599270 | Other | AL | BCBS |
| 007825700 | Medicaid | FL | |
| 111237 | Medicaid | AL | |
| 51599265 | Other | AL | BCBS |
| 51599269 | Other | AL | BCBS |
| 111224 | Medicaid | AL | |
| 111236 | Medicaid | AL | |
| 145235 | Medicaid | AL | |
| 14P2L | Other | FL | BCBS OF FLORIDA |
| 51067334 | Other | AL | BCBS |
| 51599271 | Other | AL | BCBS |
| 51599266 | Other | AL | BCBS |
| 51599267 | Other | AL | BCBS |
| 592-19398 | Other | FL | BCBS OF ALABAMA |
| P01133899 | Other | FL | RAILROAD MEDICARE |
| 111238 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 26192 (Alabama) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | ME111431 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Vincent's Birmingham | Birmingham, AL | Hospital |
| Brookwood Baptist Medical Center | Birmingham, AL | Hospital |
| Russell Medical Center | Alexander city, AL | Hospital |
| St Vincent's St Clair | Pell city, AL | Hospital |
| St Vincents Blount | Oneonta, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Orthopaedic Alliance Pllc | 2365800604 | 98 |
| Radiology Associates Of Birmingham, P.c. | 7214928571 | 42 |
| Radiology Associates Of Birmingham, P.c. | 7214928571 | 42 |
| Entity Name | University Of Alabama Health Services Foundation, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093768723 PECOS PAC ID: 1951213107 Enrollment ID: O20031105000261 |
| Entity Name | Norwood Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104879741 PECOS PAC ID: 8921996364 Enrollment ID: O20040308001107 |
| Entity Name | Inri Medical Associates, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831103837 PECOS PAC ID: 0749270197 Enrollment ID: O20040517000780 |
| Entity Name | Radiology Associates Of Birmingham, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093778706 PECOS PAC ID: 7214928571 Enrollment ID: O20040524001193 |
| Entity Name | Bioimaging Of Huntsville Inc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1801886080 PECOS PAC ID: 7416920483 Enrollment ID: O20040817001275 |
| Entity Name | Coastal Neurological Institute Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740212174 PECOS PAC ID: 4688617699 Enrollment ID: O20050609000711 |
| Entity Name | St Vincents Ambulatory Healthcare Network Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1588190441 PECOS PAC ID: 1355608456 Enrollment ID: O20171128001387 |
| Entity Name | St Vincents Ambulatory Healthcare Network Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1033646823 PECOS PAC ID: 1355608456 Enrollment ID: O20180626000597 |
| Entity Name | Cooper Green Mercy Health Services Authority An Affiliate Of Uab |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366073108 PECOS PAC ID: 0840629473 Enrollment ID: O20200402003238 |
| Entity Name | Southern Orthopaedic Alliance Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588364228 PECOS PAC ID: 2365800604 Enrollment ID: O20230620001264 |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton Waggoner, MD Po Box 9210, Pensacola, FL 32513-9210 Ph: (850) 476-8602 | Clinton Waggoner, MD 5151 N 9th Ave, Pensacola, FL 32504-8721 Ph: (850) 476-8602 |
Dr. Christopher John Manganello, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 6000 W Highway 98, Pensacola, FL 32512 Phone: 850-505-6601 | |
Robert Marcus Jr., MD Radiology Medicare: Medicare Enrolled Practice Location: 1545 Airport Blvd, Suite 1000, Pensacola, FL 32504 Phone: 850-416-6770 Fax: 850-416-7770 | |
Dr. Steven J Sukstorf, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4511 N Davis Hwy, Ste 1b, Pensacola, FL 32503 Phone: 850-484-8454 | |
Robert M Smith Ii, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1000 West Moreno Street, Pensacola, FL 32501 Phone: 850-436-4951 Fax: 850-438-6767 | |
Dr. Donald W Farmer, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 5151 N 9th Ave, Pensacola, FL 32504 Phone: 850-416-6020 | |
Dr. William R. Balchunas, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 5151 N 9th Ave, Pensacola, FL 32504 Phone: 850-416-6020 | |
Dr. Warren Ross, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: Nmotc Attn: Credentials Office, 220 Hovey Rd, Pensacola, FL 32508 Phone: 850-452-9484 |