Healthcare Provider Details

I. General information

NPI: 1841291036
Provider Name (Legal Business Name): TAMMY BONE KIGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY LEIGH BONE MD

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 NC 58 S
ELM CITY NC
27822-8079
US

IV. Provider business mailing address

303 GREEN ST E
WILSON NC
27893-4105
US

V. Phone/Fax

Practice location:
  • Phone: 252-443-7744
  • Fax: 252-443-7611
Mailing address:
  • Phone: 252-293-0013
  • Fax: 252-243-2576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200200244
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier89134PX
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: