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1316169170

NPI Code Detail

MEDICARE: JEFFREY N HIGGINBOTHAM MD

MEDICARE: JEFFREY N HIGGINBOTHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	N0831	TX
2	208VP0014X	Interventional Pain Medicine Physician	N0831	TX
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	MED-PHYS-LIC-164508	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316169170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY N HIGGINBOTHAM MD

Provider Business Mailing Address
First Line	:	2740 SOUTH AVE W STE 201
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-5137
Country	:	US
Telephone Number	:	406-541-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	2740 SOUTH AVE W STE 201
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-5137
Country	:	US
Telephone Number	:	406-541-7246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	05/26/2026

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1013937002 — JENNIFER K HELMER MSPT, CHT
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1114001765 — TARA MAHONEY WILSON MSPT, OCS, CSCS
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1669676912 — KRISTIN KATHLEEN GREEN DPT, OCS
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Practice Location Address:

2740 SOUTH AVENUE WEST , SUITE 101
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1063654283 — TAYLOR BUCKLEY M.D.
Practice Location Address:

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Directions to “ JEFFREY N HIGGINBOTHAM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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