Provider Demographics
NPI:1710081450
Name:BIGSBY, GENEEN E (DO)
Entity Type:Individual
Prefix:DR
First Name:GENEEN
Middle Name:E
Last Name:BIGSBY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-7301
Mailing Address - Country:US
Mailing Address - Phone:208-746-1383
Mailing Address - Fax:208-746-6348
Practice Address - Street 1:2315 8TH ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-7301
Practice Address - Country:US
Practice Address - Phone:208-746-1383
Practice Address - Fax:208-746-6348
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-217207V00000X
WAOP00001645207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID160043707OtherRR MEDICARE
ID1710081450OtherREGENCE BLUESHIELD OF ID
WA128876OtherLABOR & INDUSTRIES
ID1710081450Medicaid
IDS2962OtherBLUE CROSS
WA128876OtherWA L & I
WA128876OtherLABOR & INDUSTRIES
ID1710081450OtherREGENCE BLUESHIELD OF ID
WAAB11398Medicare PIN