Basic Information
| Provider Information | |||||||||
| NPI: | 1235212341 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIGBEE | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | DENNIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11765 N VISTA DEL SOL | ||||||||
| Address2: | |||||||||
| City: | ORO VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857429715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202197026 | ||||||||
| FaxNumber: | 5202197026 | ||||||||
| Practice Location | |||||||||
| Address1: | 3610 S 6 TH AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857230001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206291838 | ||||||||
| FaxNumber: | 5206291758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835G0303X | 09028 | AZ | Y | Pharmacy Service Providers | Pharmacist | Geriatric |
No ID Information.