Provider Demographics
NPI:1467143362
Name:HIGDON PLASTIC SURGERY, PLLC
Entity Type:Organization
Organization Name:HIGDON PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-444-6933
Mailing Address - Street 1:2001 MALLORY LN STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8236
Mailing Address - Country:US
Mailing Address - Phone:615-324-5647
Mailing Address - Fax:
Practice Address - Street 1:2001 MALLORY LN STE 300
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8236
Practice Address - Country:US
Practice Address - Phone:615-444-6933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty