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General NPI Number Information
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NPI Number | 1013076249
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Entity Type | Individual
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Provider Name | ERICA IRVIN HIGGINBOTHAM D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3285 BLAZER PKWY STE 200
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City | LEXINGTON
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State | KY
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Zip | 40509-2119
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Country | US
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Telephone | 859-543-0700
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Fax | 859-543-1078
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Provider Business Mailing Address
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Address Line | 3285 BLAZER PKWY STE 200
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City | LEXINGTON
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State | KY
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Zip | 40509-2119
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Country | US
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Telephone | 859-543-0700
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Fax | 859-543-1078
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7969
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License Number State | KY
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