Provider Demographics
NPI:1659484970
Name:HIGHLANDER FAMILY MEDICINE
Entity Type:Organization
Organization Name:HIGHLANDER FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
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 AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664
Mailing Address - Country:US
Mailing Address - Phone:540-459-2277
Mailing Address - Fax:540-459-3309
Practice Address - Street 1:1195 HISEY AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664
Practice Address - Country:US
Practice Address - Phone:540-459-2277
Practice Address - Fax:540-459-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09754Medicare ID - Type Unspecified