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General NPI Number Information
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NPI Number | 1255535761
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Entity Type | Organization
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Legal Business Name | CHESTER F HIGDON MD PC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 3700 BELLEMEADE AVE STE 204
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City | EVANSVILLE
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State | IN
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Zip | 47714-0126
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Country | US
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Telephone | 812-479-4080
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Fax | 812-479-4090
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Provider Business Mailing Address
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Address Line | 3700 BELLEMEADE AVE STE 204
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City | EVANSVILLE
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State | IN
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Zip | 47714-0126
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Country | US
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Telephone | 812-479-4080
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Fax | 812-479-4090
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Authorized Official
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Title or Position | MD-OWNER
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Name | DR. CHESTER F HIGDON
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Credential | MD
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Telephone | 812-479-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01025367
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License Number State | IN
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