Provider Demographics
NPI:1659681989
Name:JOSEPH HALL HIGGINSON D.M.D., M.S.O.
Entity type:Organization
Organization Name:JOSEPH HALL HIGGINSON D.M.D., M.S.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HIGGINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSO
Authorized Official - Phone:270-684-0822
Mailing Address - Street 1:2868 FARRELL CRES
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1392
Mailing Address - Country:US
Mailing Address - Phone:270-684-0822
Mailing Address - Fax:270-683-3991
Practice Address - Street 1:2868 FARRELL CRES
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1392
Practice Address - Country:US
Practice Address - Phone:270-684-0822
Practice Address - Fax:270-683-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4820332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1740403302OtherDENTIST ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS
KY1659681989Medicare NSC