MEDICARE: DR. ASHLEY C WIGGINS 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	207Q00000X	Family Medicine Physician	26951	SC

General Provider Information

NPI Number	:	1427080902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY C WIGGINS M.D.

Provider Business Mailing Address
First Line	:	313 MAIN ST
Second Line	:	SUITE B
City	:	GREENWOOD
State	:	SC
Zip	:	29646-2757
Country	:	US
Telephone Number	:	864-388-0301
Fax Number	:	864-388-0648

Provider Business Practice Location Address
First Line	:	219A N MINE ST
Second Line	:
City	:	MC CORMICK
State	:	SC
Zip	:	29835-8363
Country	:	US
Telephone Number	:	864-852-3336
Fax Number	:	864-852-3339

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	03/07/2023

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