Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 8545 | NM |
N | 111NI0900X | Internist | 8545 | NM |
Y | 207RG0300X | Geriatric Medicine | 85-45 | NM |
NPI | 1164516548 |
---|---|
Provider Name | Stephen Hightower |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Rio Rancho, NM 87124-5906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 13/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35287 | (05) | NM |
C97835 | (02) |