Provider Demographics
NPI:1780658807
Name:HIGGINS, ROBERT GEORGE (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GEORGE
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:NORTHSIDE HOSPITAL - MANAGED CARE DEPT
Mailing Address - Street 2:1000 JOHNSON FERRY RD NE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1606
Mailing Address - Country:US
Mailing Address - Phone:404-300-2476
Mailing Address - Fax:404-250-8010
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-851-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029185207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000406733Medicaid
GA005553OtherBCBS OF GEORGIA
GA10038146OtherAMERIGROUP
GA205355OtherBCBS OF GEORGIA
GA000406733GMedicaid
GA000406733FMedicaid
GA10416OtherKAISER
GA333406OtherWELLCARE OF GEORGIA
GA10416OtherKAISER
GA333406OtherWELLCARE OF GEORGIA
GA000406733GMedicaid