Healthcare Provider Details

I. General information

NPI: 1518924802
Provider Name (Legal Business Name): MICHAEL JAMES HIGBEE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S. 7TH AVENUE SUITE 150
PHOENIX AZ
85007
US

IV. Provider business mailing address

3030 N. CENTRAL AVENUE SUITE 1206
PHOENIX AZ
85012
US

V. Phone/Fax

Practice location:
  • Phone: 602-416-7600
  • Fax: 928-776-0405
Mailing address:
  • Phone: 602-416-7600
  • Fax: 928-776-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number009418
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3781
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: