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Individual

MR. FRED HIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2127 EDSEL LN NW, CORYDON, IN 47112-2030
(812) 738-1707
(812) 738-9054
Mailing address
2127 EDSEL LN NW, CORYDON, IN 47112-2030
(812) 738-1707
(812) 738-9054

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200277370
IN
01
352101814
TAX ID#
IN
Enumeration date
10/18/2006
Last updated
08/27/2008
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