Provider Demographics
NPI:1891326633
Name:WILLIAM A HIGHSMITH MD PA
Entity Type:Organization
Organization Name:WILLIAM A HIGHSMITH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTICING PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ARTIS
Authorized Official - Last Name:HIGHSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-942-9833
Mailing Address - Street 1:21 OPPORTUNITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-9185
Mailing Address - Country:US
Mailing Address - Phone:870-942-9870
Mailing Address - Fax:870-942-9837
Practice Address - Street 1:21 OPPORTUNITY DRIVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-9185
Practice Address - Country:US
Practice Address - Phone:870-942-9870
Practice Address - Fax:870-942-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1234754001Medicaid