Provider Demographics
NPI:1205821550
Name:SIGMON, WILLIAM MARK (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARK
Last Name:SIGMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 HALLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-5461
Mailing Address - Country:US
Mailing Address - Phone:828-765-8477
Mailing Address - Fax:828-765-0183
Practice Address - Street 1:1060 LENOIR RHYNE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4330
Practice Address - Country:US
Practice Address - Phone:828-328-3900
Practice Address - Fax:828-328-5253
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909071Medicaid
NC09071OtherBCBS-NC
NC246604AMedicare ID - Type Unspecified
NC09071OtherBCBS-NC
NC8909071Medicaid