MEDICARE: JOHN G HIGHFILL M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39397	CO

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00111767	OTHER	CO	RAILROAD MEDICARE
4	080153127	OTHER	CO	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200180057	OTHER	CO	TAX ID #
2	200180057	OTHER	CO	PACIFICARE
5	95999	OTHER	CO	PACIFICARE PPO
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	200180057	OTHER	CO	ROCKY MOUNTAIN HMO
8	HI657288	OTHER	CO	BCBS

NPI Number	:	1356346548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN G HIGHFILL M.D.

Provider Business Mailing Address
First Line	:	916 INDIANA AVE
Second Line	:	SUITE 110
City	:	PUEBLO
State	:	CO
Zip	:	81004-3572
Country	:	US
Telephone Number	:	719-566-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 INDIANA AVE
Second Line	:	STE 110
City	:	PUEBLO
State	:	CO
Zip	:	81004-3572
Country	:	US
Telephone Number	:	719-566-9120
Fax Number	:	719-566-9121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/15/2010

916 INDIANA AVE , SUITE 120
PUEBLO, CO
81004-3572

Practice Phone: 719-562-1122
Practice Fax: 719-562-0244

916 INDIANA AVE STE 120
PUEBLO, CO
81004-3572