DR. WIGBERTO VIVAS (NPI# 1740462399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740462399 |
| Entity Type | Individual |
| Full Name | DR. WIGBERTO VIVAS |
| Credential | MD |
| Practice Address |
620 Broad St Milledgeville GA 31062-7525 |
| Practice Telephone | 4784454128 |
| Mailing Telephone | 4784454128 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 022662 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
620 BROAD ST |
| City | MILLEDGEVILLE |
| State | GA |
| Zip Code | 31062-7525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528486784 | Frank Nelson Ragland | Respiratory Therapist, Registered | 620 Broad St, Milledgeville, GA 31062-7525 | 2014-04-03 |
| 1821225343 | Kathleen A. Martin | Nurse Practitioner | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2009-06-11 |
| 1902030307 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 620 Broad St, Milledgeville, GA 31062-7525 | 2009-05-13 |
| 1831334515 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 620 Broad St, Central Care-yarbrough Bldg-3rd Floor, Milledgeville, GA 31062-7525 | 2008-12-09 |
| 1770765745 | Cynthia B. Lee | Dentist | 620 Broad St, Milledgeville, GA 31062-7525 | 2007-12-03 |
| 1336350750 | Ernesto A Coligado | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2007-05-25 |
| 1013068030 | Charles Meyer Jr. | Psychiatry & Neurology | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2007-01-16 |
| 1790836724 | Anita Mikita | Psychiatry & Neurology | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2007-01-16 |
| 1578679122 | Yonghua Du | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-23 |
| 1205848660 | Bhagwant R Verma | Psychiatry & Neurology | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679758429 | Mary Decruise | Psychologist | 2450 Vinson Hwy, Milledgeville, GA 31062 | 2007-12-28 |
| 1922668169 | Lufti I Yargic | Psychiatry & Neurology | Csh - Cook Building 2450 Vinson Highway, Milledgeville, GA 31062-0001 | 2019-06-19 |
| 1770047276 | Ekrem Dogan | Internal Medicine | 2450 Vinson Highway Cook Building, Milledgeville, GA 31062-0001 | 2019-01-29 |
| 1144703497 | Tara Walker | Nurse Practitioner | Central State Hospital 2450 Vinson Hwy, Milledgeville, GA 31062-0001 | 2018-09-12 |
| 1356586259 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1631 Valley Cir, Milledgeville, GA 31062-0001 | 2008-12-05 |
| 1841487667 | Georgia Department of Human Resources | General Acute Care Hospital | 2400 Vinson Hwy, Milledgeville, GA 31062-0001 | 2007-09-25 |
| 1659369866 | Clinton Wade Hodges | Pharmacist | Csh Pharmaceutical Services, Lawrence Rd., Milledgeville, GA 31062-0001 | 2005-10-11 |
| 1922621184 | Uzma Beg | Psychiatry & Neurology | 2450 Vinson Highway Cook Building, Milledgeville, GA 31062-0001 | 2020-05-22 |
| 1114010485 | Jeffrey D'neil Harris | Psychologist | 2450 Vinson Highway, Milledgeville, GA 31062-1622 | 2006-10-01 |
| 1235527144 | Loukisha Monique Roberts | Registered Nurse | 2450 Vinson Highway, Milledgeville, GA 31062-5641 | 2014-12-30 |
| Find all providers in zip 31062 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811507247 | Magnolia Medical Center LLC | General Practice | 101 Chase Ct Nw Ste B, Milledgeville, GA 31061-7188 | 2020-07-31 |
| 1366847790 | Fasttrack Immediate Care of Milledgeville LLC | General Practice | 1909 N Columbia St, Milledgeville, GA 31061-2170 | 2014-10-28 |
| 1801340856 | Magnolia Medical Group, LLC | General Practice | 101 Chase Ct Nw, Suite B, Milledgeville, GA 31061-7186 | 2016-08-08 |
| 1336350750 | Ernesto A Coligado | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2007-05-25 |
| 1578679122 | Yonghua Du | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-23 |
| 1841202769 | William Deferia | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-12 |
| 1437161924 | David D Steelman | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-12 |
| 1154333946 | Armando C Santiago | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-12 |
| 1710995113 | Ikechukwu S Akunwanne | General Practice | 620 Broad St, Central State Hospital, Milledgeville, GA 31062-7525 | 2006-08-03 |
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| 1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
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| City | MILLEDGEVILLE |
| Zip Code | 31062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.