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Organization
QUEEN STREET FAMILY PRACTICE PC
Active
Organization
QUEEN STREET FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ROBERT HIGGINS DO (PRESIDENT)
(717) 741-3888
Entity
Organization
Contact information
Practice address
2471 S QUEEN ST, YORK, PA 17402-4947
(717) 741-3888
(717) 741-3709
Mailing address
2471 S QUEEN ST, YORK, PA 17402-4947
(717) 741-3888
(717) 741-3709
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010615660001
—
PA
05
—
0010615750001
—
PA
01
—
02739200
CAPITOL BLUE CROSS
PA
01
—
4I4T2629
PA BLUE SHIELD
PA
01
—
L0472628
PA BLUE SHIELD
PA
Enumeration date
02/08/2006
Last updated
08/22/2020
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