Organization
WIGGINS FAMILY PRACTICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL G WIGGINS MSN RN APRN FNP (FNP/CEO)
(912) 537-2530
Entity
Organization
Contact information
Practice address
205 ARLINGTON DR, VIDALIA, GA 30474-7209
(912) 537-2530
(912) 537-2540
Mailing address
205 ARLINGTON DR, VIDALIA, GA 30474-7209
(912) 537-2530
(912) 537-2540
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
R102724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ8960
RAILROAD MEDICARE
GA
Enumeration date
10/29/2007
Last updated
12/08/2014
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