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General NPI Number Information
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NPI Number | 1194818138
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Entity Type | Organization
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Legal Business Name | HIGHLANDS HOSPITAL CORP
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 5000 KY ROUTE 321
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9113
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Country | US
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Telephone | 606-886-8511
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Fax | 606-886-7761
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Provider Business Mailing Address
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Address Line | PO BOX 668
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City | PRESTONSBURG
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State | KY
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Zip | 41653-0668
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Country | US
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Telephone | 606-886-8511
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Fax | 606-886-7761
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Authorized Official
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Title or Position | CFO
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Name | MR. JACK G BLACKWELL
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Credential |
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Telephone | 606-886-7548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 100124
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 100124
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 100124
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License Number State | KY
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