Provider Demographics
NPI:1093015158
Name:BIGLER, JORDAN EDWIN (BC-HIS)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:EDWIN
Last Name:BIGLER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W 5150 S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-3060
Mailing Address - Country:US
Mailing Address - Phone:801-784-6900
Mailing Address - Fax:866-365-1751
Practice Address - Street 1:1818 W 5150 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-3060
Practice Address - Country:US
Practice Address - Phone:801-784-6900
Practice Address - Fax:866-365-1751
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6363387-4601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist