Individual
MR. LARRY S WIGGINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 MAYFAIR DRIVE, SUITE 201, OWENSBORO, KY 42301-4569
(270) 926-8222
(270) 685-5101
Mailing address
2211 MAYFAIR DRIVE, SUITE 201, OWENSBORO, KY 42301-4569
(270) 926-8222
(270) 685-5101
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
14856
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64148562
—
KY
Enumeration date
09/20/2006
Last updated
07/08/2007
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