Provider Demographics
NPI:1598891665
Name:HIGHLAND MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:HIGHLAND MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:828-694-3939
Mailing Address - Street 1:165 COOLRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2767
Mailing Address - Country:US
Mailing Address - Phone:828-694-3939
Mailing Address - Fax:828-692-0533
Practice Address - Street 1:165 COOLRIDGE STREET
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2767
Practice Address - Country:US
Practice Address - Phone:828-694-3939
Practice Address - Fax:828-692-0533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
NC103090363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care