Basic Information
| Provider Information | |||||||||
| NPI: | 1730148172 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIGMON | ||||||||
| FirstName: | ALICIA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO DRAWER 1239 | ||||||||
| Address2: | |||||||||
| City: | CONOVER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284643821 | ||||||||
| FaxNumber: | 8284648994 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 1ST STREET EAST | ||||||||
| Address2: | |||||||||
| City: | CONOVER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284643821 | ||||||||
| FaxNumber: | 8284648994 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2006 | ||||||||
| LastUpdateDate: | 11/19/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 101967 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | CN8132 | 01 | NC | MEDICARE RAILROAD | OTHER |