Provider Demographics
NPI:1629205752
Name:HIGGINS, MATTHEW DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DOUGLAS
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-5630
Mailing Address - Fax:423-778-3146
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE C-430
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-778-4900
Practice Address - Fax:423-778-4901
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN47906207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery