Healthcare Provider Details

I. General information

NPI: 1477378107
Provider Name (Legal Business Name): MEG BIGGS OGDEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 KRESGE WAY STE 402
LOUISVILLE KY
40207-4637
US

IV. Provider business mailing address

1215 DANT DR
GEORGETOWN IN
47122-9028
US

V. Phone/Fax

Practice location:
  • Phone: 502-895-2295
  • Fax: 502-895-2296
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC101
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: