Healthcare Provider Details

I. General information

NPI: 1336233949
Provider Name (Legal Business Name): MS. MARGUERITA HIGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARTIN ARMY COMMUNITY HOSPITAL 7590 MARNE LOOP ROAD
FT. BENNING GA
31905
US

IV. Provider business mailing address

P. O. BOX 2007
AUBURN AL
36831-2007
US

V. Phone/Fax

Practice location:
  • Phone: 706-544-1179
  • Fax:
Mailing address:
  • Phone: 334-887-8468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0862G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: