Individual
TOMMY D NIGBOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
15954 RIVERS EDGE DR, HAYWARD, WI 54843-7800
(715) 634-2541
(715) 634-5740
Mailing address
15954 RIVERS EDGE DR, HAYWARD, WI 54843-7800
(715) 634-2541
(715) 634-5740
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
708
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42938700
—
WI
Enumeration date
07/13/2006
Last updated
05/18/2021
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