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General NPI Number Information
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NPI Number | 1144594326
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Entity Type | Organization
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Legal Business Name | TOM WIGGINTON MEDICAL, INC.
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 12616 W 62ND TERR. SUITE 115C
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City | SHAWNEE
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State | KS
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Zip | 66216
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Country | US
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Telephone | 913-283-7725
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Fax | 913-422-8858
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Provider Business Mailing Address
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Address Line | 12616 W 62ND TERR. SUITE 115C
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City | SHAWNEE
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State | KS
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Zip | 66216
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Country | US
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Telephone | 913-283-7725
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Fax | 913-422-8858
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | TOM WIGGINTON
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Credential |
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Telephone | 913-908-6857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 16.12180
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License Number State | KS
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