Provider Demographics
NPI:1750335121
Name:BIGGS, FRED D (MD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:D
Last Name:BIGGS
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 1:100 MERCY WAY STE 320-330
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MERCY WAY STE 320-330
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-781-5387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6024207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
33202011OtherBLUE SHIELD OF KC HMO
4596969OtherAETNA PPO
33202011OtherPHP FREEDOM
060068300OtherMEDICARE RAILROAD
4596969OtherAETNA
4596969OtherAETNA HMO
MO1205853389Medicaid
431092652 A003OtherCHAMPUS TRICARE
33202011OtherBLUE SHIELD OF KC PPO
MOMA3395002Medicare PIN
060068300OtherMEDICARE RAILROAD
A11670Medicare UPIN
MO4548607AMedicare ID - Type Unspecified