Provider Demographics
NPI:1235872466
Name:HIGHLEY, GREGORY A JR
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:HIGHLEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 JILL CT
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9108
Mailing Address - Country:US
Mailing Address - Phone:937-541-3632
Mailing Address - Fax:
Practice Address - Street 1:1029 JILL CT
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-9108
Practice Address - Country:US
Practice Address - Phone:937-541-3632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant