Provider Demographics
NPI:1649838491
Name:BIGELOW, JASON DEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:DEAN
Last Name:BIGELOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 OLD CLEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-6853
Mailing Address - Country:US
Mailing Address - Phone:775-881-2502
Mailing Address - Fax:
Practice Address - Street 1:700 OLD CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-6853
Practice Address - Country:US
Practice Address - Phone:775-881-2502
Practice Address - Fax:775-881-2509
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18118183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist