Organization
NIGHT LIGHT PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY D TWIGGS M.D. (PRESIDENT)
(435) 628-8034
Entity
Organization
Contact information
Practice address
1240 E 100 S STE 14, ST GEORGE, UT 84790-3005
(435) 628-8034
Mailing address
1240 E 100 S STE 14, ST GEORGE, UT 84790-3005
(435) 628-8034
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
88-178110-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09165
—
UT
Enumeration date
03/29/2007
Last updated
07/25/2007
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