Provider Demographics
NPI:1750442976
Name:SIGMON, MICHAEL RICHARD (O D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RICHARD
Last Name:SIGMON
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2063 15TH AVENUE PL SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-8340
Mailing Address - Country:US
Mailing Address - Phone:828-322-2606
Mailing Address - Fax:828-322-3163
Practice Address - Street 1:2063 15TH AVENUE PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8340
Practice Address - Country:US
Practice Address - Phone:828-322-2606
Practice Address - Fax:828-322-3163
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890982KMedicaid
NCNC4630AMedicare PIN
NC5512490001Medicare NSC
NC890982KMedicaid