Provider Demographics
NPI:1922278050
Name:HIGGS, SCOTT HUNTER (PT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:HUNTER
Last Name:HIGGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-3317
Mailing Address - Country:US
Mailing Address - Phone:985-386-6884
Mailing Address - Fax:985-386-6854
Practice Address - Street 1:132 S 6TH ST
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-3317
Practice Address - Country:US
Practice Address - Phone:985-386-6884
Practice Address - Fax:985-386-6854
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3B982G938Medicare PIN