Healthcare Provider Details

I. General information

NPI: 1083978357
Provider Name (Legal Business Name): BRIAN G BIGGERSTAFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10005 N 60TH ST
OMAHA NE
68152-1625
US

IV. Provider business mailing address

10005 N 60TH ST
OMAHA NE
68152-1625
US

V. Phone/Fax

Practice location:
  • Phone: 402-547-8514
  • Fax:
Mailing address:
  • Phone: 402-547-8514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberTEP6749
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: