Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 30606 | KY |
NPI | 1073517066 |
---|---|
Provider Name | Mark E Bigler |
First Address | Bowling Green, KY 42101-1759 |
Second Address | Bowling Green, KY 42101-1759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 01/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64306061 | (05) | KY |
F90684 | (02) | KY |