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General NPI Number Information
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NPI Number | 1306157409
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Entity Type | Individual
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Provider Name | DUSTIN CARL HIGGINS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 1025 MAINE ST
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City | QUINCY
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State | IL
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Zip | 62301-4038
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Country | US
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Telephone | 217-222-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 MAINE ST
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City | QUINCY
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State | IL
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Zip | 62301-4038
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Country | US
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Telephone | 217-222-6550
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Fax |
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 2012023541
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036138828
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License Number State | IL
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