Individual
DR. GREGORY MARK WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
205 ARLINGTON DR, VIDALIA, GA 30474-7209
(912) 537-2559
(912) 537-9668
Mailing address
205 ARLINGTON DR, VIDALIA, GA 30474-7209
(912) 537-2559
(912) 537-9668
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000802
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00725018A
—
GA
01
—
1254360001
DMERC
—
01
—
1477535474
BLUE CROSS
—
Enumeration date
11/16/2005
Last updated
11/13/2007
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