Provider Demographics
NPI:1154743573
Name:BIGELOW, TUESDAY M (MD)
Entity type:Individual
Prefix:
First Name:TUESDAY
Middle Name:M
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2516
Mailing Address - Country:US
Mailing Address - Phone:256-259-5950
Mailing Address - Fax:256-259-5954
Practice Address - Street 1:1202 S BROAD ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2516
Practice Address - Country:US
Practice Address - Phone:256-259-5950
Practice Address - Fax:256-259-5954
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL197692086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000026688Medicaid
AL000026688Medicaid