MEDICARE: DR. MARK ALLEN WIGGER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	42939	KY
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	MD.36009	AL
3	207R00000X	Internal Medicine Physician	15826	TN
4	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	15826	TN
5	207RC0000X	Cardiovascular Disease Physician	MD15826	TN
6	207RC0000X	Cardiovascular Disease Physician	MD.36009	AL
7	207RC0000X	Cardiovascular Disease Physician	42939	KY
8	207RC0000X	Cardiovascular Disease Physician	15826	TN
9	207RN0300X	Nephrology Physician	MD.36009	AL
10	207RN0300X	Nephrology Physician	42939	KY
11	207RN0300X	Nephrology Physician	15826	TN

General Provider Information

NPI Number	:	1306884150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ALLEN WIGGER M.D.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 TVC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0001
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	02/12/2024

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