Provider Demographics
NPI:1427359090
Name:HIGHLANDS PEDIATRICS
Entity Type:Organization
Organization Name:HIGHLANDS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-623-8100
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-0570
Mailing Address - Country:US
Mailing Address - Phone:276-623-8100
Mailing Address - Fax:276-623-8126
Practice Address - Street 1:191 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2934
Practice Address - Country:US
Practice Address - Phone:276-623-8100
Practice Address - Fax:276-623-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059370208000000X
VA0101051074208000000X
VA0101050628208000000X
VA0101243877208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty