| Todd Higginbotham, Pa | |
|
126 South Main Street Leachville AR 72438 | |
| (870) 539-6621 | |
| (870) 539-6334 |
| Full Name | Todd Higginbotham, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 126 South Main Street, Leachville, Arkansas |
| Authorized Official Name and Position | Wade Uglem (MANAGER) |
| Authorized Official Contact | 8705396621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Higginbotham, Pa Po Box 109 Leachville AR 72438-0109 Ph: (870) 539-6621 | Todd Higginbotham, Pa 126 South Main Street Leachville AR 72438 Ph: (870) 539-6621 |
| NPI Number | 1699910034 |
|---|---|
| Provider Enumeration Date | 12/15/2008 |
| Last Update Date | 12/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699910034 | NPI | - | NPPES |
| 5F953 | Other | AR | BLUE CROSS BLUE SHIELD GROUP ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3393 (Arkansas) | Primary |