Provider Demographics
NPI:1326488891
Name:HIGDON, ALICE A (DO)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:A
Last Name:HIGDON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:ANN
Other - Last Name:HIGDON WILHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1532 LONE OAK RD STE 235
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003
Practice Address - Country:US
Practice Address - Phone:270-442-9463
Practice Address - Fax:270-442-2241
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04313208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery