Provider Demographics
NPI:1871947853
Name:WIGINTON, JAMES GARVIN IV (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GARVIN
Last Name:WIGINTON
Suffix:IV
Gender:
Credentials:DO
Other - Prefix:MR
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:WIGINTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:109 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5608
Practice Address - Country:US
Practice Address - Phone:864-797-7150
Practice Address - Fax:864-797-7155
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91263207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty