MEDICARE: DR. ELLEN B HIGHT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD08779	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548240971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLEN B HIGHT MD

Provider Business Mailing Address
First Line	:	1351 S COUNTY TRL
Second Line	:	SUITE 301
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-5079
Country	:	US
Telephone Number	:	401-398-0860
Fax Number	:	401-398-0861

Provider Business Practice Location Address
First Line	:	1351 S COUNTY TRL
Second Line	:	SUITE 301
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-5079
Country	:	US
Telephone Number	:	401-398-0860
Fax Number	:	401-398-0861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/08/2007

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