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Individual

DR. CHARLES CLAYTON WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
7100 SIX FORKS RD, SUITE 301, RALEIGH, NC 27615-6156
(919) 847-0187
(919) 863-2862
Mailing address
2346 WALNUT ST, CARY, NC 27518-9210
(919) 851-0093
(919) 859-4172

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1094
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7909975
NC
01
P01334941
RAILROAD MEDICARE
NC
Enumeration date
09/06/2006
Last updated
08/25/2014
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