Provider Demographics
NPI:1215064522
Name:BIGHAM, JAMES R II (D,M,D)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:BIGHAM
Suffix:II
Gender:M
Credentials:D,M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 STATE ROUTE 261 STE A
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2668
Mailing Address - Country:US
Mailing Address - Phone:812-853-0625
Mailing Address - Fax:812-853-0614
Practice Address - Street 1:4333 STATE ROUTE 261 STE A
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2668
Practice Address - Country:US
Practice Address - Phone:812-853-0625
Practice Address - Fax:812-853-0614
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120073211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice