Healthcare Provider Details

I. General information

NPI: 1982700571
Provider Name (Legal Business Name): BRIAN P HIGGINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 N VAUGHAN ST
BRUSLY LA
70719-2225
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-749-2645
  • Fax: 225-749-8216
Mailing address:
  • Phone: 225-526-0013
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number024237
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: