Individual
DARYL W. BIGELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1740 GRANDE BLVD SE, SUITE B, RIO RANCHO, NM 87124-1799
(505) 892-3434
(505) 891-2402
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 246-2622
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
416
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881418
—
AZ
01
—
NM00PA10
BC BS OF NM
NM
01
—
P00151438
MEDICARE ID
NM
05
—
P2065
—
NM
Enumeration date
07/13/2005
Last updated
04/25/2008
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