MEDICARE: DR. SAMUEL DAVID BIGLEY 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	OEG001536	PA

General Provider Information

NPI Number	:	1851381461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL DAVID BIGLEY O.D.

Provider Business Mailing Address
First Line	:	RR 2 BOX 70
Second Line	:	HORNERTOWN ROAD
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-9504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 N CHESTNUT ST
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-1714
Country	:	US
Telephone Number	:	724-887-5820
Fax Number	:	724-887-5825

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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