Provider Demographics
NPI:1235191693
Name:HIGHLEY, CHRISTOPHER CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:HIGHLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9120 DOUBLE DIAMOND PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4842
Mailing Address - Country:US
Mailing Address - Phone:775-204-0150
Mailing Address - Fax:775-501-6360
Practice Address - Street 1:9120 DOUBLE DIAMOND PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521
Practice Address - Country:US
Practice Address - Phone:775-204-0150
Practice Address - Fax:775-501-6360
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500117Medicaid
NVH96769Medicare UPIN
NV38178 GT.WCHGDMedicare ID - Type Unspecified