Provider Demographics
NPI:1538709720
Name:WIGGINTON, PETER JAMES
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JAMES
Last Name:WIGGINTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-1402
Mailing Address - Country:US
Mailing Address - Phone:859-628-0818
Mailing Address - Fax:
Practice Address - Street 1:423 WARDS CORNER RD STE B
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8341
Practice Address - Country:US
Practice Address - Phone:859-414-6487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other