| Dr Jon Anthony Wagnon, DO | |
|
1368 Dadrian Professional Park, Godfrey, IL 62035-1685 | |
| (618) 433-9701 | |
| (618) 433-9706 |
| Full Name | Dr Jon Anthony Wagnon |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 21 Years |
| Location | 1368 Dadrian Professional Park, Godfrey, Illinois |
| 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 |
|---|---|---|---|
| 1265623268 | NPI | - | NPPES |
| 036120316 | Medicaid | IL |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Francis Hospital | Litchfield, IL | Hospital |
| Alton Memorial Hospital | Alton, IL | Hospital |
| Osf Saint Anthony's Health Center | Alton, IL | Hospital |
| Memorial Hospital | Belleville, IL | Hospital |
| Jersey Community Hospital | Jerseyville, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cepamerica Illinois Llp | 3274793633 | 492 |
| Entity Name | St Francis Hospital of the Hospital Sisters of the Third Order of St F |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326057076 PECOS PAC ID: 5890686562 Enrollment ID: O20040323000066 |
| Entity Name | Cepamerica Illinois LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912283110 PECOS PAC ID: 3274793633 Enrollment ID: O20120322000587 |
| Entity Name | Optimal Health Medicine LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316299332 PECOS PAC ID: 1254583164 Enrollment ID: O20121128000361 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jon Anthony Wagnon, DO 1368 Dadrian Professional Park, Godfrey, IL 62035-1685 Ph: (618) 433-9701 | Dr Jon Anthony Wagnon, DO 1368 Dadrian Professional Park, Godfrey, IL 62035-1685 Ph: (618) 433-9701 |
Mr. James J Hopper, PA-C Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5520 Godfrey Rd Ste B, Godfrey, IL 62035 Phone: 618-463-7800 |