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NPI Code Detail

MEDICARE: JAMES RAY HIGGINBOTHAM C.N.P

MEDICARE:   JAMES RAY HIGGINBOTHAM  C.N.P
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
1363L00000XNurse PractitionerRN271748OH

General Provider Information

NPI Number : 1780622670
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES RAY HIGGINBOTHAM C.N.P
Provider Business Mailing Address
First Line : 659 BOULEVARD ST
Second Line :
City : DOVER
State : OH
Zip : 44622-2026
Country : US
Telephone Number : 330-602-0767
Fax Number : 330-365-3831
Provider Business Practice Location Address
First Line : 659 BOULEVARD ST
Second Line :
City : DOVER
State : OH
Zip : 44622-2026
Country : US
Telephone Number : 330-602-0767
Fax Number : 330-365-3831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 04/21/2010

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Directions to “ JAMES RAY HIGGINBOTHAM C.N.P” Practice Location

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