1871661637 NPI number — JAMIE L HIGLEY DC PC

Table of content: (NPI 1871661637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871661637 NPI number — JAMIE L HIGLEY DC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMIE L HIGLEY DC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HIGLEY FAMILY CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871661637
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3430 ANDERSON HWY STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWHATAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23139-5834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-598-6300
Provider Business Mailing Address Fax Number:
804-598-8755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3430 ANDERSON HWY STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POWHATAN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23139-5834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-598-6300
Provider Business Practice Location Address Fax Number:
804-598-8755
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HIGLEY
Authorized Official First Name:
JAMIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT CHIROPRACTOR
Authorized Official Telephone Number:
804-598-6300

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0104001731 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 118548 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1356334908 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007349 . This is a "ASHN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7026087 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0104001731 . This is a "VA STATE LISC. NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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