Provider Demographics
NPI:1992722565
Name:HIGGINS, WILLIAM H (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
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 1:8618 N 35TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3800
Mailing Address - Country:US
Mailing Address - Phone:602-249-0999
Mailing Address - Fax:602-249-6020
Practice Address - Street 1:8618 N 35TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3800
Practice Address - Country:US
Practice Address - Phone:602-249-0999
Practice Address - Fax:602-249-6020
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1260207Q00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ237405Medicaid
E85912Medicare UPIN
AZ237405Medicaid