Provider Demographics
NPI:1518924802
Name:HIGBEE, MICHAEL JAMES (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:HIGBEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N. CENTRAL AVENUE
Mailing Address - Street 2:SUITE 1206
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012
Mailing Address - Country:US
Mailing Address - Phone:602-416-7600
Mailing Address - Fax:928-776-0405
Practice Address - Street 1:1201 S. 7TH AVENUE
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007
Practice Address - Country:US
Practice Address - Phone:602-416-7600
Practice Address - Fax:928-776-0405
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009418363AM0700X
AZ3781363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5827L2T081Medicare PIN
NY5827L37061Medicare ID - Type Unspecified
5827LBW911Medicare ID - Type Unspecified
NY5827L37062Medicare ID - Type Unspecified