Healthcare Provider Details

I. General information

NPI: 1407853351
Provider Name (Legal Business Name): DOROTHY P. WIGGINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY PALMORE

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4579 S COBB DR SE STE 300
SMYRNA GA
30080-6389
US

IV. Provider business mailing address

4579 S COBB DR SE STE 300
SMYRNA GA
30080-6389
US

V. Phone/Fax

Practice location:
  • Phone: 404-699-1339
  • Fax: 404-699-1380
Mailing address:
  • Phone: 404-699-1339
  • Fax: 404-699-1380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number045137
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: