Provider Demographics
NPI:1285908210
Name:HIGGS, BOBBY CLARK (MD)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:CLARK
Last Name:HIGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 HIGHWAY 45 BYP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-4436
Mailing Address - Country:US
Mailing Address - Phone:731-664-4220
Mailing Address - Fax:
Practice Address - Street 1:1804 HIGHWAY 45 BYP
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-4436
Practice Address - Country:US
Practice Address - Phone:731-664-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN02684207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine