Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME136802 | FL |
NPI | 1013371301 |
---|---|
Provider Name | Brian Higdon |
First Address | Jacksonville, FL 32216-4252 |
Second Address | Pittsburgh, PA 15213-3215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 01/07/2021 |