Basic Information
| Provider Information | |||||||||
| NPI: | 1801065081 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THOMAS HIGGINS, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9000 EXECUTIVE PARK DR | ||||||||
| Address2: | STE C200 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656706199 | ||||||||
| FaxNumber: | 8656706158 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 20TH ST | ||||||||
| Address2: | STE 303 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379161809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655411375 | ||||||||
| FaxNumber: | 8655411717 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2008 | ||||||||
| LastUpdateDate: | 03/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | HIGGINS | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8655411375 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MD 16285 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 3883808 | 05 | TN | MEDICAID |