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NPI Code Detail

MEDICARE: EUGENE O WIGGS M.D.

MEDICARE:   EUGENE O WIGGS  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
1174400000XSpecialist13970CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113970OTHERCOLICENSE

General Provider Information

NPI Number : 1992741961
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUGENE O WIGGS M.D.
Provider Business Mailing Address
First Line : 55 MADISON ST STE 355
Second Line :
City : DENVER
State : CO
Zip : 80206-5429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 55 MADISON ST STE 355
Second Line :
City : DENVER
State : CO
Zip : 80206-5429
Country : US
Telephone Number : 303-377-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 07/08/2007

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Directions to “ EUGENE O WIGGS M.D.” Practice Location

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