| Shane Higginbotham Md Pa | |
|
1580 Tanner St Rockport AR 72104-2023 | |
| (501) 337-9994 | |
| (501) 337-9964 |
| Full Name | Shane Higginbotham Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1580 Tanner St, Rockport, Arkansas |
| Authorized Official Name and Position | Kim Overton (OFFICE MANAGER) |
| Authorized Official Contact | 5013379994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shane Higginbotham Md Pa 1580 Tanner St Rockport AR 72104-2023 Ph: (501) 337-9994 | Shane Higginbotham Md Pa 1580 Tanner St Rockport AR 72104-2023 Ph: (501) 337-9994 |
| NPI Number | 1104106426 |
|---|---|
| Provider Enumeration Date | 08/17/2011 |
| Last Update Date | 08/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104106426 | NPI | - | NPPES |
| 205795002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E0968 (Arkansas) | Primary |