Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | T02974 | MO |
NPI | 1013043165 |
---|---|
Provider Name | Dr. Douglas George Biggs |
First Address | Independence, MO 64055-4411 |
Second Address | Columbia, MO 65203-1085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2007 |
Last Update Date | 08/07/2007 |