Healthcare Provider Details

I. General information

NPI: 1437547577
Provider Name (Legal Business Name): FRANCES WIGGINS MCNEILL MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS FRANCES BARRETT WIGGINS

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E WOODROW WILSON AVE
JACKSON MS
39216-5116
US

IV. Provider business mailing address

300 BOB WHITE LN
RIDGELAND MS
39157-9450
US

V. Phone/Fax

Practice location:
  • Phone: 601-362-4471
  • Fax:
Mailing address:
  • Phone: 601-946-3769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: