Individual
DR. STANLEY D. WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2115 S FREMONT AVE, SUITE 4300, SPRINGFIELD, MO 65804-2239
(417) 820-3911
(417) 820-3924
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
100610
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
100610
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203371612
—
MO
Enumeration date
09/25/2006
Last updated
05/26/2015
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