Provider Demographics
NPI:1700808177
Name:HIGH, CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:HIGH
Suffix:
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:PO BOX 390
Mailing Address - Street 2:909 GORMAN AVE.
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-0390
Mailing Address - Country:US
Mailing Address - Phone:304-636-9242
Mailing Address - Fax:304-636-8152
Practice Address - Street 1:909 GORMAN AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4109
Practice Address - Country:US
Practice Address - Phone:304-636-9242
Practice Address - Fax:304-636-8152
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13007207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001720619OtherBCBS
WV13007OtherWV STATE LICENSE
WV0056511001Medicaid
WV550661804OtherTAX ID
WV550661804OtherTAX ID
WVAH9529364OtherDEA LICENSE #