Healthcare Provider Details

I. General information

NPI: 1346993185
Provider Name (Legal Business Name): CLAIRE WILLIAMS HIGGINBOTHAM PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 RHEA COUNTY HWY
DAYTON TN
37321-5817
US

IV. Provider business mailing address

3405 RHEA COUNTY HWY
DAYTON TN
37321-5817
US

V. Phone/Fax

Practice location:
  • Phone: 423-594-0444
  • Fax: 423-594-0445
Mailing address:
  • Phone: 423-594-0444
  • Fax: 423-594-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4881
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: