Provider Demographics
NPI:1528053113
Name:BIGHAM, JAMES C (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:BIGHAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 CROSS VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-5238
Mailing Address - Country:US
Mailing Address - Phone:812-401-7777
Mailing Address - Fax:812-429-0392
Practice Address - Street 1:634 CROSS VALLEY CIR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-5238
Practice Address - Country:US
Practice Address - Phone:812-401-7777
Practice Address - Fax:812-429-0392
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003181A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200394590AMedicaid
INP00928487OtherRAILROAD MEDICARE
IN000000244130OtherANTHEM
IN22479OtherNVA
IN6503910001OtherDMERC
IN16096OtherSPECTERA
IN7288496OtherAETNA
INBI1466240OtherHIGHMARK CLARITY VISION
IN200394590AMedicaid
IN193660AMedicare PIN