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Contact Information

KENNON D WIGLEY, MD
2700 E 29TH STREET
SUITE 220
BRYAN, TX77802
 Phone: 979-774-4008
 Fax: 979-774-7893
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KENNON D WIGLEY · (Male)

NPI Number 1215904495
Status Active
Credentials MD
Entity Individual
Enumeration date 03/07/2006
Last updated 06/13/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • TX License # G5771
Hospital affiliation(s)
  • BELLVILLE GENERAL HOSPITAL - (Acute Care)
    44 N CUMMINGS
    BELLVILLE, TX 77418
  • SCOTT & WHITE HOSPITAL BRENHAM - (Acute Care)
    700 MEDICAL PARKWAY
    BRENHAM, TX 77833
  • ST JOSEPH REGIONAL HEALTH CENTER - (Acute Care)
    2801 FRANCISCAN DR
    BRYAN, TX 77802
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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