Basic Information
| Provider Information | |||||||||
| NPI: | 1194764456 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIGGINS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 645 E MISSOURI AVE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850121351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022628900 | ||||||||
| FaxNumber: | 6022628890 | ||||||||
| Practice Location | |||||||||
| Address1: | 5757 W THUNDERBIRD RD | ||||||||
| Address2: | SUITE W-400 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853064641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025471400 | ||||||||
| FaxNumber: | 6025471401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 04/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 4317 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.