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General NPI Number Information
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NPI Number | 1043305337
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Entity Type | Organization
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Legal Business Name | PETER A WIGGIN DPM INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 74 WOOD ST
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City | MANSFIELD
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State | OH
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Zip | 44903-2211
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Country | US
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Telephone | 419-756-1875
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Fax | 419-525-3264
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Provider Business Mailing Address
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Address Line | 74 WOOD ST
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City | MANSFIELD
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State | OH
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Zip | 44903-2211
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Country | US
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Telephone | 419-756-1875
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Fax | 419-525-3264
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER AUSTIN WIGGIN
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Credential | D.P.M.
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Telephone | 419-756-1875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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