Provider Demographics
NPI:1023450467
Name:HIGGINS, BOYD DOUGLAS (PHARMD)
Entity type:Individual
Prefix:
First Name:BOYD
Middle Name:DOUGLAS
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 W 78TH ST
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-9579
Mailing Address - Country:US
Mailing Address - Phone:952-470-1006
Mailing Address - Fax:
Practice Address - Street 1:4307 NW URBANDALE DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7910
Practice Address - Country:US
Practice Address - Phone:159-544-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist