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Organization
SHEPHERD OF HOPE CLINIC PC
Active
Organization
SHEPHERD OF HOPE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS JOHN WIGTON D.O. (DIRECTOR)
(231) 946-7360
Entity
Organization
Contact information
Practice address
1028 HANNAH AVE, SUITE D, TRAVERSE CITY, MI 49686-2963
(231) 946-7360
(231) 929-4775
Mailing address
1028 HANNAH AVE, SUITE D, TRAVERSE CITY, MI 49686-2963
(231) 946-7360
(231) 929-4775
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100506
—
MI
Enumeration date
12/16/2005
Last updated
07/21/2022
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