# SHEPHERD OF HOPE CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225014715
- **Authorized official:** DR. DOUGLAS JOHN WIGTON D.O. (DIRECTOR)
- **Authorized official phone:** (231) 946-7360

## Contact information

- **Practice address:** 1028 HANNAH AVE, SUITE D, TRAVERSE CITY, MI 49686-2963
- **Practice address phone:** (231) 946-7360
- **Practice address fax:** (231) 929-4775
- **Mailing address:** 1028 HANNAH AVE, SUITE D, TRAVERSE CITY, MI 49686-2963
- **Mailing address phone:** (231) 946-7360
- **Mailing address fax:** (231) 929-4775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | MI | Yes |

## Other

- **Enumeration date:** 12/16/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2100506 | — | MI |