Healthcare Provider Details

I. General information

NPI: 1144151556
Provider Name (Legal Business Name): MONICA WIGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 COSHOCTON AVE
MOUNT VERNON OH
43050-1476
US

IV. Provider business mailing address

1575 COSHOCTON AVE
MOUNT VERNON OH
43050-1476
US

V. Phone/Fax

Practice location:
  • Phone: 740-392-3305
  • Fax:
Mailing address:
  • Phone: 740-392-3305
  • Fax: 740-392-3410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOP.017894-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: