Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 19769 | AL |
NPI | 1154743573 |
---|---|
Provider Name | Tuesday M Bigelow |
First Address | Scottsboro, AL 35768-2516 |
Second Address | Scottsboro, AL 35768-2516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2014 |
Last Update Date | 21/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000026688 | (05) | AL |
E10500 | (02) | AL |