Individual
DIANA R TWIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1888 S 14TH ST, CREDENTIALING DEPARTMENT, FERNANDINA BEACH, FL 32034-3054
(904) 261-0922
(904) 277-8872
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 78633
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2735903-00
—
FL
01
—
P00253287
MEDICARE RR
—
Enumeration date
11/30/2005
Last updated
12/31/2018
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