Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2001014986 | MO |
NPI | 1073693909 |
---|---|
Provider Name | Gary R. Highfill |
First Address | Belfast, ME 04915-4005 |
Second Address | Fort Smith, AR 72901-5182 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 28/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148435001 | (05) | AR |
200171840A | (05) | OK |