Provider Demographics
NPI:1659528974
Name:HIGGINS, PETER SPURGEON (PA-C)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:SPURGEON
Last Name:HIGGINS
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 1:318 WHITE HORSE PIKE
Mailing Address - Street 2:ADVOCARE HEIGHTS PRIMARY CARE
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1705
Mailing Address - Country:US
Mailing Address - Phone:856-547-6000
Mailing Address - Fax:856-546-3189
Practice Address - Street 1:318 WHITE HORSE PIKE
Practice Address - Street 2:ADVOCARE HEIGHTS PRIMARY CARE
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1705
Practice Address - Country:US
Practice Address - Phone:856-547-6000
Practice Address - Fax:856-546-3189
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000984363AM0700X
NJ25MP00217900363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ077356Medicare PIN