Provider Demographics
NPI:1326199910
Name:HIGHLANDER FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:HIGHLANDER FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MACLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-459-2277
Mailing Address - Street 1:1195 HISEY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-2003
Mailing Address - Country:US
Mailing Address - Phone:540-459-2277
Mailing Address - Fax:
Practice Address - Street 1:1195 HISEY AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-2003
Practice Address - Country:US
Practice Address - Phone:540-459-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010274184Medicaid
VA00W944H01Medicare ID - Type Unspecified
VA010274184Medicaid