Provider Demographics
NPI:1821045584
Name:BIGSBY, GLENN E IV (DO)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:E
Last Name:BIGSBY
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 SOUTH BROADWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2633
Mailing Address - Country:US
Mailing Address - Phone:303-955-7574
Mailing Address - Fax:720-242-9307
Practice Address - Street 1:7780 SOUTH BROADWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2633
Practice Address - Country:US
Practice Address - Phone:303-955-7574
Practice Address - Fax:720-242-9307
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0054364207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00001354OtherRAILROAD MEDICARE
CO51383870Medicaid
CO51383870Medicaid
CO393353Medicare PIN
FLU0696ZMedicare PIN