Provider Demographics
NPI:1255461778
Name:BIGLER, ERIN DAVID (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:DAVID
Last Name:BIGLER
Suffix:
Gender:M
Credentials:PHD
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 1968
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84603-1968
Mailing Address - Country:US
Mailing Address - Phone:801-374-8536
Mailing Address - Fax:801-374-1072
Practice Address - Street 1:2483 N CANYON RD
Practice Address - Street 2:201
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-5943
Practice Address - Country:US
Practice Address - Phone:801-377-1072
Practice Address - Fax:801-377-1079
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT116117-2501103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist