Provider Demographics
NPI:1871659045
Name:HIGGINBOTHAM, RODNEY JAMES (OT)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:JAMES
Last Name:HIGGINBOTHAM
Suffix:
Gender:M
Credentials:OT
Other - Prefix:MR
Other - First Name:R
Other - Middle Name:J
Other - Last Name:HIGGINBOTHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:7078 ROCKY ROAD LOOP
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-8926
Mailing Address - Country:US
Mailing Address - Phone:205-586-0130
Mailing Address - Fax:
Practice Address - Street 1:901 COMMERCE DR STE A
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2835
Practice Address - Country:US
Practice Address - Phone:251-200-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2193225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2193OtherOT LICENSE