Provider Demographics
NPI:1982700571
Name:HIGGINS, BRIAN P (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
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 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0013
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:402 N VAUGHAN ST
Practice Address - Street 2:
Practice Address - City:BRUSLY
Practice Address - State:LA
Practice Address - Zip Code:70719-2225
Practice Address - Country:US
Practice Address - Phone:225-749-2645
Practice Address - Fax:225-749-8216
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0102342OtherUNITED HEALTHCARE
LA119001264545OtherHUMANA
LA1574180Medicaid
LA7046551OtherAETNA
LA4E451Medicare ID - Type UnspecifiedINDIVIDUAL
LA1574180Medicaid
LA119001264545OtherHUMANA
LAP00116552Medicare ID - Type UnspecifiedRAILROAD MEDICARE