Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 49375 | CO |
NPI | 1457457020 |
---|---|
Provider Name | Ruth Higdon |
First Address | Grand Junction, CO 81502-1687 |
Second Address | Grand Junction, CO 81505-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 13/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32807031 | (05) | CO |
B63154 | (02) | AK |
MD70991 | (05) | AK |