Provider Demographics
NPI:1811037625
Name:DR JIM HIGHFILL
Entity Type:Organization
Organization Name:DR JIM HIGHFILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:DAN
Authorized Official - Last Name:HIGHFILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-762-5335
Mailing Address - Street 1:1618 N 5TH
Mailing Address - Street 2:SUITE 4 DR JIM HIGHFILL DDS
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601
Mailing Address - Country:US
Mailing Address - Phone:580-762-5335
Mailing Address - Fax:580-762-5474
Practice Address - Street 1:1618 N 5TH
Practice Address - Street 2:SUITE 4
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601
Practice Address - Country:US
Practice Address - Phone:580-762-5335
Practice Address - Fax:580-762-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty