Healthcare Provider Details

I. General information

NPI: 1376542100
Provider Name (Legal Business Name): HIGHLAND EMERGENCY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 N HIGH ST
HILLSBORO OH
45133-8273
US

IV. Provider business mailing address

4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US

V. Phone/Fax

Practice location:
  • Phone: 937-393-6100
  • Fax: 937-393-6333
Mailing address:
  • Phone: 800-875-0136
  • Fax: 937-619-4231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1402095
License Number StateOH

VIII. Authorized Official

Name: MR. WILLIAM A COLE JR.
Title or Position: CEO
Credential: MD
Phone: 937-312-3627