Provider Demographics
NPI:1871517706
Name:HIGGINS, JANET YOUNGBLOOD (MD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:YOUNGBLOOD
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:YOUNGBLOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:CBO2-3, CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-263-8571
Mailing Address - Fax:513-263-8622
Practice Address - Street 1:608 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3001
Practice Address - Country:US
Practice Address - Phone:513-585-0404
Practice Address - Fax:513-564-6885
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38149207R00000X
OH35-08-0408-H207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH18501Medicare UPIN
OHHI4068665Medicare ID - Type UnspecifiedMIDDLETOWN MEDICARE #
OHHI4068661Medicare ID - Type UnspecifiedMILFORD MEDICARE #
OHHI4068663Medicare ID - Type UnspecifiedKETTERING MEDICARE #
OHHI4068667Medicare ID - Type UnspecifiedFAIRBORN MEDICARE #
OHHI4068666Medicare ID - Type UnspecifiedDAYTON MEDICARE #
OHHI4068664Medicare ID - Type UnspecifiedCOLERAIN MEDICARE #
OHHI4068662Medicare ID - Type UnspecifiedSPRINGDALE MEDICARE #