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NPI Code Detail

MEDICARE: DR. ABIGAIL TATE WINGLER

MEDICARE: DR. ABIGAIL TATE WINGLER
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
1183500000XPharmacist2022010907MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12022010907OTHERMOMISSOURI BOARD OF PHARMACY LICENSE NUMBER

General Provider Information

NPI Number : 1538801576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABIGAIL TATE WINGLER
Provider Business Mailing Address
First Line : 1060 TWIN OAKS DR
Second Line :
City : DOE RUN
State : MO
Zip : 63637-3190
Country : US
Telephone Number : 636-375-9283
Fax Number :
Provider Business Practice Location Address
First Line : 1025 HIGHWAY 72 BYP
Second Line :
City : FREDERICKTOWN
State : MO
Zip : 63645-7326
Country : US
Telephone Number : 573-783-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 07/18/2025

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