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Individual

SHELBY WIGGINTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2708 S RIFE MEDICAL LN STE 130, ROGERS, AR 72758-1455
(479) 338-5555
(479) 338-5533
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 543-6979
(314) 364-6321

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
94-09485
KS
207Q00000X
Family Medicine Physician
Primary
E-16541
AR

Other

Enumeration date
06/11/2018
Last updated
08/08/2023
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