MEDICARE: BIGGS MEDICAL CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	025105	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	025105	OTHER	GA	STATE OF GEORGIA MEDICAL LICENSE
2	1063415776	OTHER	GA	BARBARA C. BIGGS, MD NPI NUMBER

General Provider Information

NPI Number	:	1568696029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIGGS MEDICAL CLINIC, LLC

Provider Business Mailing Address
First Line	:	1431 WHITE CIR
Second Line	:	SUITE F
City	:	MARIETTA
State	:	GA
Zip	:	30066-5801
Country	:	US
Telephone Number	:	678-797-6830
Fax Number	:	770-424-5557

Provider Business Practice Location Address
First Line	:	1431 WHITE CIR
Second Line	:	SUITE F
City	:	MARIETTA
State	:	GA
Zip	:	30066-5801
Country	:	US
Telephone Number	:	678-797-6830
Fax Number	:	770-424-5557

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BARBARA C BIGGS
Credential	:	M.D.
Telephone Number	:	678-797-6830

Provider Enumeration Date	:	05/12/2009
Last Update Date	:	05/12/2009

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