Healthcare Provider Details

I. General information

NPI: 1720235260
Provider Name (Legal Business Name): JEREMY SCOTT BIGGE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MARY ST
EVANSVILLE IN
47710
US

IV. Provider business mailing address

600 MARY ST
EVANSVILLE IN
47710-1658
US

V. Phone/Fax

Practice location:
  • Phone: 812-450-5000
  • Fax: 812-471-6650
Mailing address:
  • Phone: 812-450-5000
  • Fax: 812-471-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberDO1787
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number02003771A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: