Provider Demographics
NPI:1871661637
Name:JAMIE L HIGLEY DC PC
Entity Type:Organization
Organization Name:JAMIE L HIGLEY DC PC
Other - Org Name:HIGLEY FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-598-6300
Mailing Address - Street 1:3430 ANDERSON HWY STE C
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5834
Mailing Address - Country:US
Mailing Address - Phone:804-598-6300
Mailing Address - Fax:804-598-8755
Practice Address - Street 1:3430 ANDERSON HWY STE C
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5834
Practice Address - Country:US
Practice Address - Phone:804-598-6300
Practice Address - Fax:804-598-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA118548OtherANTHEM
VA1356334908OtherINDIVIDUAL NPI
VA1007349OtherASHN
VA7026087OtherAETNA
VA0104001731OtherVA STATE LISC. NUMBER
VA0104001731OtherVA STATE LISC. NUMBER
VAU78215Medicare UPIN