Provider Demographics
NPI:1881707263
Name:HIGDON, CHESTER F (MD)
Entity type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:F
Last Name:HIGDON
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 1:3700 BELLEMEADE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0126
Mailing Address - Country:US
Mailing Address - Phone:812-479-4080
Mailing Address - Fax:812-479-4090
Practice Address - Street 1:3700 BELLEMEADE AVE STE 204
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0126
Practice Address - Country:US
Practice Address - Phone:812-479-4080
Practice Address - Fax:812-479-4090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010253672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000042409OtherANTHEM BC & BS
IN846200AMedicare PIN
INB29633Medicare UPIN