Provider Demographics
NPI:1013043165
Name:BIGGS, DOUGLAS GEORGE (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:GEORGE
Last Name:BIGGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12513 E 40TH ST S
Mailing Address - Street 2:APT. E
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4411
Mailing Address - Country:US
Mailing Address - Phone:816-252-7343
Mailing Address - Fax:
Practice Address - Street 1:2301 W WORLEY ST
Practice Address - Street 2:J C PENNEY OPTICAL
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-1085
Practice Address - Country:US
Practice Address - Phone:573-445-9750
Practice Address - Fax:573-445-2917
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02974152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist