Provider Demographics
NPI:1700034501
Name:HIGGINBOTHAM, RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:HIGGINBOTHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6325 HOSPITAL PKWY
Mailing Address - Street 2:EMORY JOHNS CREEK HOSPITAL - DEPT. OF RADIOLOGY
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5775
Mailing Address - Country:US
Mailing Address - Phone:678-474-7024
Mailing Address - Fax:678-474-7025
Practice Address - Street 1:6325 HOSPITAL PKWY
Practice Address - Street 2:EMORY JOHNS CREEK HOSPITAL - DEPT. OF RADIOLOGY
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5775
Practice Address - Country:US
Practice Address - Phone:678-474-7025
Practice Address - Fax:678-474-2025
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2013-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA677582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology