Individual
DEREK WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
713 WINFIELD DUNN PKWY STE 9, SEVIERVILLE, TN 37876-5533
(865) 429-9110
Mailing address
284 ALMONT AVE, ALMONT, MI 48003-8601
(810) 417-1056
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4837
TN
363A00000X
Physician Assistant
5601009759
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4837
STATE LICENCE
TN
01
—
5601009759
STATE LICENSE
MI
Enumeration date
04/22/2020
Last updated
08/02/2024
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