Provider Demographics
NPI:1952722175
Name:WIGTON EYE CARE ASSOCIATES,INC
Entity Type:Organization
Organization Name:WIGTON EYE CARE ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WIGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-458-7440
Mailing Address - Street 1:16 PINE GROVE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4451
Mailing Address - Country:US
Mailing Address - Phone:724-458-7440
Mailing Address - Fax:724-458-0732
Practice Address - Street 1:16 PINE GROVE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4451
Practice Address - Country:US
Practice Address - Phone:724-458-7440
Practice Address - Fax:724-458-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty