Provider Demographics
NPI:1780766469
Name:HIGGINS, THOMAS G (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 20TH ST
Mailing Address - Street 2:STE 303
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1809
Mailing Address - Country:US
Mailing Address - Phone:865-670-6728
Mailing Address - Fax:
Practice Address - Street 1:9000 EXECUTIVE PARK DR
Practice Address - Street 2:C200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4685
Practice Address - Country:US
Practice Address - Phone:865-670-6132
Practice Address - Fax:865-670-6188
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD162852084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA97871Medicare UPIN
TN3883808Medicare ID - Type UnspecifiedMC PROVIDER NUMBER