MEDICARE: MICHAEL JAMES HIGBEE PA-C

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	363AM0700X	Medical Physician Assistant	009418	NY
2	363A00000X	Physician Assistant	3781	AZ

General Provider Information

NPI Number	:	1518924802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JAMES HIGBEE PA-C

Provider Business Mailing Address
First Line	:	3030 N. CENTRAL AVENUE
Second Line	:	SUITE 1206
City	:	PHOENIX
State	:	AZ
Zip	:	85012
Country	:	US
Telephone Number	:	602-416-7600
Fax Number	:	928-776-0405

Provider Business Practice Location Address
First Line	:	1201 S. 7TH AVENUE
Second Line	:	SUITE 150
City	:	PHOENIX
State	:	AZ
Zip	:	85007
Country	:	US
Telephone Number	:	602-416-7600
Fax Number	:	928-776-0405

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	05/21/2019

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