Provider Demographics
NPI:1811947914
Name:BIGLEY, G. KIM (MD)
Entity type:Individual
Prefix:DR
First Name:G.
Middle Name:KIM
Last Name:BIGLEY
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 1:75 PRINGLE WAY
Mailing Address - Street 2:STE 910
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8405
Mailing Address - Country:US
Mailing Address - Phone:775-324-2234
Mailing Address - Fax:775-324-6015
Practice Address - Street 1:85 KIRMAN AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1339
Practice Address - Country:US
Practice Address - Phone:775-324-2234
Practice Address - Fax:775-324-6015
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4301174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016016Medicaid
NV002016016Medicaid
NVC46515Medicare UPIN