Provider Demographics
NPI:1235374539
Name:WIGGINS, KATHRYN JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:JOAN
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:96 JONATHAN LUCAS ST
Mailing Address - Street 2:ROOM 819, CLINICAL SCIENCES BUILDING
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-8900
Mailing Address - Country:US
Mailing Address - Phone:843-792-4122
Mailing Address - Fax:843-792-8399
Practice Address - Street 1:96 JONATHAN LUCAS ST
Practice Address - Street 2:ROOM 819, CLINICAL SCIENCES BUILDING
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8900
Practice Address - Country:US
Practice Address - Phone:843-792-4122
Practice Address - Fax:843-792-8399
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL31330174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist