MEDICARE: DR. JACKSON T. BIGGS 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	2084P0800X	Psychiatry Physician	E9541	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	760129220	OTHER	TX	COMMERCIAL
2	0003JT	OTHER	TX	BLUE CROSS BLUE SHIELD
3	76012922077964A001	OTHER	TX	TRICARE
4	0003JT	OTHER	TX	BLUECROSS/SHIELD GROUP ID
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	E9541	OTHER	TX	UNICARE CLASSIC
7	B21268	OTHER	TX	OTHER GROUP ID

General Provider Information

NPI Number	:	1821093493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACKSON T. BIGGS M.D.

Provider Business Mailing Address
First Line	:	161 LAY ST
Second Line	:
City	:	HALLETTSVILLE
State	:	TX
Zip	:	77964-3519
Country	:	US
Telephone Number	:	361-798-5168
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 LAY ST
Second Line	:
City	:	HALLETTSVILLE
State	:	TX
Zip	:	77964-3519
Country	:	US
Telephone Number	:	361-798-5168
Fax Number	:

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	12/05/2011

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Directions to “ DR. JACKSON T. BIGGS M.D.” Practice Location

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