| Higginbotham Family Clinic | |
|
1002 Schneider Dr Suite 104 Malvern AR 72104-4816 | |
| (501) 332-7981 | |
| (501) 337-9964 |
| Full Name | Higginbotham Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1002 Schneider Dr, Malvern, Arkansas |
| Authorized Official Name and Position | Kim Overton (OFFICE MANAGER) |
| Authorized Official Contact | 5013379994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Higginbotham Family Clinic 1002 Schneider Dr Suite 104 Malvern AR 72104-4816 Ph: (501) 332-7981 | Higginbotham Family Clinic 1002 Schneider Dr Suite 104 Malvern AR 72104-4816 Ph: (501) 332-7981 |
| NPI Number | 1033129713 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 05/06/2021 |
| Medicare PECOS PAC ID | 8022276732 |
|---|---|
| Medicare Enrollment ID | O20120228000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033129713 | NPI | - | NPPES |
| 205795002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E0968 (Arkansas) | Primary |
| 363A00000X | Physician Assistant | PA251 (Arkansas) | Secondary |
| Provider Name | Michael S Higginbotham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619992377 PECOS PAC ID: 5991778482 Enrollment ID: I20040813000378 |
| Provider Name | Kerry R Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164889002 PECOS PAC ID: 0042502320 Enrollment ID: I20160706002261 |
| Provider Name | Kristyn Bennett Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326425919 PECOS PAC ID: 7618304460 Enrollment ID: I20200218000103 |
| Provider Name | John Mark Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114524436 PECOS PAC ID: 8022429067 Enrollment ID: I20201124001875 |
| Provider Name | Marykatherine Callison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740956721 PECOS PAC ID: 4284028937 Enrollment ID: I20220223002452 |
| Provider Name | Lyssa Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972269785 PECOS PAC ID: 4385039965 Enrollment ID: I20220317000708 |
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