Healthcare Provider Details

I. General information

NPI: 1457355331
Provider Name (Legal Business Name): RONALD A HIGGINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 09/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CARONDELET DR STE 125
KANSAS CITY MO
64114-4846
US

IV. Provider business mailing address

11420 CANTERBURY CIR
LEAWOOD KS
66211-2935
US

V. Phone/Fax

Practice location:
  • Phone: 816-942-1150
  • Fax: 816-942-0322
Mailing address:
  • Phone: 913-491-3850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number30187
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: