Provider Demographics
NPI:1851381461
Name:BIGLEY, SAMUEL DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DAVID
Last Name:BIGLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 70
Mailing Address - Street 2:HORNERTOWN ROAD
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-9504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1714
Practice Address - Country:US
Practice Address - Phone:724-887-5820
Practice Address - Fax:724-887-5825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001536152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080953RSXMedicare ID - Type Unspecified
PAV00446Medicare UPIN