MEDICARE: DR. KARLA D HIGGINBOTHAM M.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
1	207Q00000X	Family Medicine Physician	ME142530	FL
2	207Q00000X	Family Medicine Physician	2022-00599	NC
3	207Q00000X	Family Medicine Physician	R4715	TX
4	208D00000X	General Practice Physician	125064109	IL

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	:	1366884926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLA D HIGGINBOTHAM M.D.

Provider Business Mailing Address
First Line	:	2436 N SHARON AMITY RD STE 102
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-8401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2436 N SHARON AMITY RD STE 102
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-8401
Country	:	US
Telephone Number	:	980-202-0675
Fax Number	:

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

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	03/04/2026

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Directions to “ DR. KARLA D HIGGINBOTHAM M.D.” Practice Location

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