Provider Demographics
NPI:1982601225
Name:HIGGINS, BRIAN EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:EDWARD
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 SCHORRWAY DR NW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8410
Mailing Address - Country:US
Mailing Address - Phone:740-681-1582
Mailing Address - Fax:740-681-1586
Practice Address - Street 1:2036 SCHORRWAY DR NW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8410
Practice Address - Country:US
Practice Address - Phone:740-681-1582
Practice Address - Fax:740-681-1586
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004102208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0637065Medicaid
A16538Medicare UPIN
OH0637065Medicaid