Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 019.032501 | IL |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 7487 | OK |
NPI | 1710413091 |
---|---|
Provider Name | Kathleen Higgins |
First Address | Oklahoma City, OK 73117-1214 |
Second Address | Oklahoma City, OK 73117-1214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2017 |
Last Update Date | 15/11/2021 |