Provider Demographics
NPI:1457355331
Name:HIGGINS, RONALD A (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 CANTERBURY CIR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-2935
Mailing Address - Country:US
Mailing Address - Phone:913-491-3850
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:STE 125
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4846
Practice Address - Country:US
Practice Address - Phone:816-942-1150
Practice Address - Fax:816-942-0322
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO30187174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C50047Medicare UPIN