Healthcare Provider Details

I. General information

NPI: 1962329615
Provider Name (Legal Business Name): BIGGERSTAFF FACIAL PLASTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3965 W 106TH ST STE 120
CARMEL IN
46032-7781
US

IV. Provider business mailing address

3965 W 106TH ST STE 120
CARMEL IN
46032-7781
US

V. Phone/Fax

Practice location:
  • Phone: 317-602-6332
  • Fax:
Mailing address:
  • Phone: 317-602-6332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BIGGERSTAFF
Title or Position: OWNER
Credential: MD
Phone: 317-602-6332