Linda A. Waggoner Fountain
Pediatrician Pediatric Infectious Diseases
1204 W Main St
Charlottesville
, Virginia 22903-2824
Linda A. Waggoner Fountain
Pediatrician Pediatric Infectious Diseases
1204 W Main St
Charlottesville
, Virginia 22903-2824
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About
Features
Specialties
- Pediatrician
- Pediatric Infectious Diseases
Languages spoken
- English
Location
First Address
- Linda A. Waggoner Fountain
- Po Box 9007
- Charlottesville, VA
- Zip : 22906-9007
- Phone :
Second Address
- Linda A. Waggoner Fountain
- 1204 W Main St
- Charlottesville, VA
- Zip : 22903-2824
- Fax : (434) 243-3300
- Phone : (434) 924-0123
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 0101048721 | VA |
| Y | 2080P0208X | Pediatric Infectious Diseases | 0101048721 | VA |
National Provider Identifier
| NPI | 1013086651 |
|---|---|
| Provider Name | Linda A. Waggoner Fountain |
| First Address | Charlottesville, VA 22906-9007 |
| Second Address | Charlottesville, VA 22903-2824 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/11/2006 |
| Last Update Date | 16/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1013086651 | (05) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.