MEDICARE: DAVID L WIGTON DC

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	111N00000X	Chiropractor	1015	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871586107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L WIGTON DC

Provider Business Mailing Address
First Line	:	922 E COLUMBUS ST
Second Line	:	PO BOX 114
City	:	KENTON
State	:	OH
Zip	:	43326-1683
Country	:	US
Telephone Number	:	419-673-3111
Fax Number	:	419-673-8619

Provider Business Practice Location Address
First Line	:	922 E COLUMBUS ST
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-1683
Country	:	US
Telephone Number	:	419-673-3111
Fax Number	:	419-673-8619

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	05/21/2008

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Directions to “ DAVID L WIGTON DC” Practice Location

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