Provider Demographics
NPI:1720211618
Name:HIGHLANDS MEDICAL PARTNERS II
Entity Type:Organization
Organization Name:HIGHLANDS MEDICAL PARTNERS II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-7548
Mailing Address - Street 1:5230 KY ROUTE 321
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9168
Mailing Address - Country:US
Mailing Address - Phone:606-886-7747
Mailing Address - Fax:606-886-1316
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE 2
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-7747
Practice Address - Fax:606-886-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic