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Individual

MR. ALTON RANCE WIGGINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2105 E SOUTH BLVD, MONTGOMERY, AL 36116-2409
(334) 386-4242
Mailing address
PO BOX 235022, MONTGOMERY, AL 36123-5022
(334) 386-2051
(334) 396-6929

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1101051
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051555088
BLUE CROSS
AL
05
051555088
AL
Enumeration date
05/17/2006
Last updated
08/21/2014
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