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NPI Code Detail

MEDICARE: MR. ALTON RANCE WIGGINS CRNA

MEDICARE: MR. ALTON RANCE WIGGINS CRNA
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
1367500000XCertified Registered Nurse Anesthetist1101051AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2051555088OTHERALBLUE CROSS

General Provider Information

NPI Number : 1902858640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALTON RANCE WIGGINS CRNA
Provider Business Mailing Address
First Line : PO BOX 235022
Second Line :
City : MONTGOMERY
State : AL
Zip : 36123-5022
Country : US
Telephone Number : 334-386-2051
Fax Number : 334-396-6929
Provider Business Practice Location Address
First Line : 2105 E SOUTH BLVD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36116-2409
Country : US
Telephone Number : 334-386-4242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 08/21/2014

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