Jonathan J Wiggenhorn
Facial Plastic Surgeon
2700 N 140th Avenue Ste 107
Goodyear
, Arizona 85395
Jonathan J Wiggenhorn
Facial Plastic Surgeon
2700 N 140th Avenue Ste 107
Goodyear
, Arizona 85395
(623) 535-8771
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Jonathan J Wiggenhorn
- 2700 N 140th Ave Ste 107
- Goodyear, AZ
- Zip : 85395-2439
- Fax : (623) 535-8771
- Phone : (623) 537-7085
Second Address
- Jonathan J Wiggenhorn
- 2700 N 140th Avenue Ste 107
- Goodyear, AZ
- Zip : 85395
- Fax : (623) 353-8771
- Phone : (623) 353-8770
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | 4738 | AZ |
National Provider Identifier
| NPI | 1417983230 |
|---|---|
| Provider Name | Jonathan J Wiggenhorn |
| First Address | Goodyear, AZ 85395-2439 |
| Second Address | Goodyear, AZ 85395 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/06/2006 |
| Last Update Date | 17/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 272504 | (05) | AZ |
| I54820 | (02) | AZ |
| Z136680 | (02) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.