MEDICARE: GENE O. BIGHAM M.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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	J6337	TX
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	J6337	TX
3	207R00000X	Internal Medicine Physician	J6337	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	82V275	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538126719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENE O. BIGHAM M.D.

Provider Business Mailing Address
First Line	:	2727 BOLTON BOONE DR STE 114
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2019
Country	:	US
Telephone Number	:	469-857-3142
Fax Number	:	469-857-3077

Provider Business Practice Location Address
First Line	:	2727 BOLTON BOONE DR STE 114
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2019
Country	:	US
Telephone Number	:	469-857-3142
Fax Number	:	469-857-3077

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

Provider Enumeration Date	:	04/30/2006
Last Update Date	:	04/17/2025

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

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