Basic Information
Provider Information
NPI: 1235472507
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIGGINS
FirstName: PATRICK
MiddleName: RYAN
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5050 POPLAR AVE STE 800
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381570800
CountryCode: US
TelephoneNumber: 9012762662
FaxNumber: 9012742033
Practice Location
Address1: 5050 POPLAR AVE STE 800
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381570800
CountryCode: US
TelephoneNumber: 9012762662
FaxNumber: 9012742033
Other Information
ProviderEnumerationDate: 04/04/2013
LastUpdateDate: 07/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X3201TNN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200X3201TNN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001X3201TNY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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