Provider Demographics
NPI:1528801222
Name:HIGGINS, BROOKE VICTORIA (MD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:VICTORIA
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:660 SOUTH EUCLID AVE
Mailing Address - Street 2:CAMPUS BOX 8109
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1093
Mailing Address - Country:US
Mailing Address - Phone:314-362-8028
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES JEWISH PLAZA
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-362-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2024022541208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery