Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 23222 | AZ |
N | 207ND0101X | MOHS-Micrographic Surgeon | 23222 | AZ |
N | 207ND0900X | Dermatopathologist | 23222 | AZ |
NPI | 1225054240 |
---|---|
Provider Name | Carl Frederick Bigler |
First Address | Flagstaff, AZ 86001-1383 |
Second Address | Flagstaff, AZ 86001-1383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 11/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070008139 | RXR MEDICARE (01) | AR |
132522 | (05) | AZ |