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NPI Code Detail

MEDICARE: DR. SEAN T HIGGINS MD

MEDICARE: DR. SEAN T HIGGINS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramBP10074482TX
2208600000XSurgery Physician112059GA

General Provider Information

NPI Number : 1629650676
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN T HIGGINS MD
Provider Business Mailing Address
First Line : 114 S EASTERN AVE
Second Line :
City : BARTLETT
State : IL
Zip : 60103-4202
Country : US
Telephone Number : 847-736-6787
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3899
Country : US
Telephone Number : 770-219-8730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2021
Last Update Date : 06/08/2026

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