Provider Demographics
NPI:1952404311
Name:HIGBY, RAYMOND F JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:F
Last Name:HIGBY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6428 NUMBER FOUR ROAD
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367
Mailing Address - Country:US
Mailing Address - Phone:315-376-3430
Mailing Address - Fax:315-376-3186
Practice Address - Street 1:6428 NUMBER FOUR ROAD
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367
Practice Address - Country:US
Practice Address - Phone:315-376-3430
Practice Address - Fax:315-376-3186
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012012-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11317107OtherCAQH
V00685Medicare UPIN