Provider Demographics
NPI:1740412063
Name:HIGGINS, STEPHEN RAY (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RAY
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 OLD SPRINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-4005
Mailing Address - Country:US
Mailing Address - Phone:205-838-6917
Mailing Address - Fax:
Practice Address - Street 1:2152 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-4005
Practice Address - Country:US
Practice Address - Phone:205-838-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL3086R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine