Healthcare Provider Details

I. General information

NPI: 1245603828
Provider Name (Legal Business Name): MATTHEW HIGHFIELD NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 MONTGOMERY RD
CINCINNATI OH
45242-4402
US

IV. Provider business mailing address

WOUND SPECIALISTS OF GREATER CINCINNATI LLC PO BOX 643911
CINCINNATI OH
45264-3911
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-5050
  • Fax:
Mailing address:
  • Phone: 513-557-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: