Provider Demographics
NPI:1245975382
Name:PIGOTT, RAYMOND DUANE JR
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DUANE
Last Name:PIGOTT
Suffix:JR
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 1:944 LAKE FLOYD CIR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:WV
Mailing Address - Zip Code:26426-7386
Mailing Address - Country:US
Mailing Address - Phone:304-365-1436
Mailing Address - Fax:
Practice Address - Street 1:944 LAKE FLOYD CIR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:WV
Practice Address - Zip Code:26426-7386
Practice Address - Country:US
Practice Address - Phone:304-365-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant