Provider Demographics
NPI:1609964402
Name:BIGLER, JONATHAN ALLAN (PA)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ALLAN
Last Name:BIGLER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1029
Mailing Address - Street 2:
Mailing Address - City:MEADE
Mailing Address - State:KS
Mailing Address - Zip Code:67864-1029
Mailing Address - Country:US
Mailing Address - Phone:620-518-1197
Mailing Address - Fax:
Practice Address - Street 1:410 CHEYENNE
Practice Address - Street 2:
Practice Address - City:SATANTA
Practice Address - State:KS
Practice Address - Zip Code:67870-8748
Practice Address - Country:US
Practice Address - Phone:620-649-2771
Practice Address - Fax:620-649-2538
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KST00835OtherLICENSE