Provider Demographics
NPI:1073733002
Name:HIGHLANDS JOINT AND SPINE ORTHOPEDICS
Entity Type:Organization
Organization Name:HIGHLANDS JOINT AND SPINE ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-386-5555
Mailing Address - Street 1:2373 US HWY 27 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4926
Mailing Address - Country:US
Mailing Address - Phone:863-386-5555
Mailing Address - Fax:863-382-2561
Practice Address - Street 1:2373 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4926
Practice Address - Country:US
Practice Address - Phone:863-386-5555
Practice Address - Fax:863-382-2561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME85558207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL=========OtherEIN
FLK5248Medicare ID - Type Unspecified