Provider Demographics
NPI:1730167255
Name:BIGLER, GREGORY THARIN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:THARIN
Last Name:BIGLER
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 1:9499 W CHARLESTON BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7150
Mailing Address - Country:US
Mailing Address - Phone:702-933-9393
Mailing Address - Fax:702-933-6789
Practice Address - Street 1:9499 W CHARLESTON BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7150
Practice Address - Country:US
Practice Address - Phone:702-933-9393
Practice Address - Fax:702-933-6789
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6243207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4258506OtherAETNA
CC6820OtherBXBS
P00149474OtherR.R. MEDICARE
NV2019162Medicaid
NVCP788Z PTANOtherMEDICARE PTAN
C91950Medicare UPIN
83058Medicare ID - Type Unspecified