Provider Demographics
NPI:1356539118
Name:HIGHLAND PEDIATRICS PLLC
Entity type:Organization
Organization Name:HIGHLAND PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-798-5227
Mailing Address - Street 1:409 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-2607
Mailing Address - Country:US
Mailing Address - Phone:601-798-5227
Mailing Address - Fax:601-798-5271
Practice Address - Street 1:409 CARROLL ST
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-2607
Practice Address - Country:US
Practice Address - Phone:601-798-5227
Practice Address - Fax:601-798-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty