Provider Demographics
NPI:1467116988
Name:BIGSBY, FERNANDO LEON
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:LEON
Last Name:BIGSBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-4636
Mailing Address - Country:US
Mailing Address - Phone:216-804-3201
Mailing Address - Fax:
Practice Address - Street 1:58 CHARLES ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-4636
Practice Address - Country:US
Practice Address - Phone:216-804-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care