Individual
DR. JACOB ANTHONY HIGGINBOTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2611 TUCKER STATION RD, LOUISVILLE, KY 40299-4546
(941) 962-3566
Mailing address
2611 TUCKER STATION RD, LOUISVILLE, KY 40299-4546
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26029902A
IN
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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