Provider Demographics
NPI:1821171661
Name:BIGLES-GEIGEL, JOSE LUIS (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:BIGLES-GEIGEL
Suffix:
Gender:M
Credentials:MD
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 2898
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30015-7898
Mailing Address - Country:US
Mailing Address - Phone:770-786-1234
Mailing Address - Fax:678-718-6977
Practice Address - Street 1:4159 MILL ST NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2546
Practice Address - Country:US
Practice Address - Phone:770-786-1234
Practice Address - Fax:678-712-6977
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA063170207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ12056OtherSPECTERA VISION
NJ3K6307OtherHEALTHNET#
NJ0146500OtherGHI PPO#
NJ52146OtherDAVIS VISION
NJ7910916OtherAETNA PPO#
NJ1444166OtherAETNA HMO#
NJNJ8134OtherEYE MED VISION
NJP00418212OtherRAILROAD MEDICARE#
NJ2834977000OtherAMERIHEALTH#
NJP3792437OtherOXFORD#
NJ608B21OtherEMPIRE BCBS#
NJ7910916OtherAETNA PPO#