MEDICARE: ALLYSON M BIGHAM O.D.

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	152W00000X	Optometrist	18003226A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1500168	OTHER	IN	HIGHMARK CLARITY VISION
2	000000299910	OTHER	IN	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356337661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON M BIGHAM O.D.

Provider Business Mailing Address
First Line	:	2417 W FRANKLIN ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47712-5564
Country	:	US
Telephone Number	:	812-423-5000
Fax Number	:	812-423-6838

Provider Business Practice Location Address
First Line	:	2417 W FRANKLIN ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47712-5564
Country	:	US
Telephone Number	:	812-423-5000
Fax Number	:	812-423-6838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	01/21/2013

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Directions to “ ALLYSON M BIGHAM O.D.” Practice Location

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