Provider Demographics
NPI:1619900826
Name:HIGHLAND RIM RESPIRATORY SPECIALISTS
Entity Type:Organization
Organization Name:HIGHLAND RIM RESPIRATORY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-520-8457
Mailing Address - Street 1:315 N WASHINGTON AVE
Mailing Address - Street 2:STE 230
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2660
Mailing Address - Country:US
Mailing Address - Phone:931-520-8457
Mailing Address - Fax:931-520-6373
Practice Address - Street 1:315 N WASHINGTON AVE
Practice Address - Street 2:STE 230
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2660
Practice Address - Country:US
Practice Address - Phone:931-520-8457
Practice Address - Fax:931-520-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374966Medicaid
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