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Organization
SHANE HIGGINBOTHAM MD PA
Active
Organization
SHANE HIGGINBOTHAM MD PA
Active
Other names
Higginbotham Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KIM OVERTON (OFFICE MANAGER)
(501) 337-9994
Entity
Organization
Contact information
Practice address
1580 TANNER ST, ROCKPORT, AR 72104-2023
(501) 337-9994
(501) 337-9964
Mailing address
1580 TANNER ST, ROCKPORT, AR 72104-2023
(501) 337-9994
(501) 337-9964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0968
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205795002
—
AR
Enumeration date
08/17/2011
Last updated
08/02/2023
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