Wigberto Vivas, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

022662 Issued in GA

Practice address

620 Broad St
Milledgeville, GA 31062-7525

Phone

(478) 445-4128

NPI assigned

Dec 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1740462399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BROAD ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310627525",
            "telephone_number": "478-445-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BROAD ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310627525",
            "telephone_number": "478-445-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVAS",
        "first_name": "WIGBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "022662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serlenia Veal
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• Bhagwant R Verma, M.D.
• Vickie M Brown
• Voyage of Hope, LLC
• Marlena Hostetter Waddell, OTR/L
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1121)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Walgreen Co (Rite Aid #11839)

• General Practice Physician in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.