Provider Demographics
NPI:1700850765
Name:HIGHLEY, MONT FREDERICK III (MD)
Entity Type:Individual
Prefix:DR
First Name:MONT
Middle Name:FREDERICK
Last Name:HIGHLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7104 UNIVERSITY COURT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117
Mailing Address - Country:US
Mailing Address - Phone:334-215-0711
Mailing Address - Fax:334-215-0710
Practice Address - Street 1:7104 UNIVERSITY COURT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-215-0711
Practice Address - Fax:334-215-0710
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5501207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL02864Medicaid
AL02865Medicare ID - Type Unspecified
ALC70127Medicare UPIN