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NPI Code Detail

MEDICARE: DR. LARRY WAYNE HIGGS O.D.

MEDICARE:  DR. LARRY WAYNE HIGGS  O.D.
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
1152W00000XOptometrist0229OK

Other Identifiers

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

General Provider Information

NPI Number : 1366449225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY WAYNE HIGGS O.D.
Provider Business Mailing Address
First Line : 17 S OAK ST
Second Line :
City : SAPULPA
State : OK
Zip : 74066-4312
Country : US
Telephone Number : 918-224-2610
Fax Number : 918-224-0613
Provider Business Practice Location Address
First Line : 17 S OAK ST
Second Line :
City : SAPULPA
State : OK
Zip : 74066-4312
Country : US
Telephone Number : 918-224-2610
Fax Number : 918-224-0613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 02/12/2009

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Directions to “ DR. LARRY WAYNE HIGGS O.D.” Practice Location

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