Individual
PRESTON A. WIGFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
196 NORTH ST, GENEVA GENERAL HOSPITAL, GENEVA, NY 14456-1651
(315) 787-4500
Mailing address
196 NORTH ST, EMERGENCY DEPARTMENT, GENEVA, NY 14456-1651
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
156463
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02642193
—
NY
Enumeration date
11/01/2006
Last updated
10/05/2007
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