Provider Demographics
NPI:1528228541
Name:HIGHTOWER, OLIVIA B (MD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:B
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2569
Mailing Address - Country:US
Mailing Address - Phone:228-575-2902
Mailing Address - Fax:228-575-2917
Practice Address - Street 1:1340 BROAD AVE STE 330
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2464
Practice Address - Country:US
Practice Address - Phone:228-575-1234
Practice Address - Fax:228-867-4828
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22634207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology