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General NPI Number Information
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NPI Number | 1720350267
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Entity Type | Organization
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Legal Business Name | G D HIGHSMITH DC PC
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 2426 NEWTON ST
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City | JASPER
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State | IN
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Zip | 47546-1326
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Country | US
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Telephone | 812-482-6133
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Fax | 812-482-1581
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Provider Business Mailing Address
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Address Line | 2426 NEWTON ST
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City | JASPER
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State | IN
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Zip | 47546-1326
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Country | US
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Telephone | 812-482-6133
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Fax | 812-482-1581
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Authorized Official
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Title or Position | PRES.
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Name | GREGORY HIGHSMITH
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Credential | DC
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Telephone | 812-482-6133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 08000576A
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License Number State | IN
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