Provider Demographics
NPI:1871589499
Name:HIGGINS, STEPHEN WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 DAVIS AVE E
Mailing Address - Street 2:
Mailing Address - City:BARKSDALE AFB
Mailing Address - State:LA
Mailing Address - Zip Code:71110-2278
Mailing Address - Country:US
Mailing Address - Phone:318-456-0483
Mailing Address - Fax:
Practice Address - Street 1:245 DAVIS AVE E
Practice Address - Street 2:
Practice Address - City:BARKSDALE AFB
Practice Address - State:LA
Practice Address - Zip Code:71110-2278
Practice Address - Country:US
Practice Address - Phone:318-456-0483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine