Individual
DR. RAPHAEL JOHN HIGGINBOTHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
927 E PRUDHOMME ST, OPELOUSAS, LA 70570-8240
(337) 594-8381
Mailing address
5018 VIDRINE RD, VILLE PLATTE, LA 70586-8707
(504) 473-8079
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
025644
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04333
—
LA
Enumeration date
05/20/2006
Last updated
07/08/2007
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